Provider Demographics
NPI:1649598806
Name:WEIR, JENNIFER (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:WEIR
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:C
Other - Last Name:SCHREYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:1505 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7507
Mailing Address - Country:US
Mailing Address - Phone:910-239-3562
Mailing Address - Fax:877-889-2993
Practice Address - Street 1:1505 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7507
Practice Address - Country:US
Practice Address - Phone:910-239-3562
Practice Address - Fax:877-889-2993
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003575133N00000X
NC1024019133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist