Provider Demographics
NPI:1760744262
Name:LANGENFELD, JANE LENORE (RD)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:LENORE
Last Name:LANGENFELD
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5682 W. GARY DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-1263
Mailing Address - Country:US
Mailing Address - Phone:480-940-3884
Mailing Address - Fax:
Practice Address - Street 1:5682 W. GARY DRIVE
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-1263
Practice Address - Country:US
Practice Address - Phone:480-940-3884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered