Provider Demographics
NPI:1639691736
Name:KEY, JANE O (RDN)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:O
Last Name:KEY
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 WISTERIA DR
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45419-3453
Mailing Address - Country:US
Mailing Address - Phone:937-545-8027
Mailing Address - Fax:
Practice Address - Street 1:138 WISTERIA DR
Practice Address - Street 2:
Practice Address - City:OAKWOOD
Practice Address - State:OH
Practice Address - Zip Code:45419-3453
Practice Address - Country:US
Practice Address - Phone:937-545-8027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3233133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered