Provider Demographics
NPI:1932497682
Name:PIPER, JAMIE L (RD)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:PIPER
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:PO BOX 23340
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63156-3340
Mailing Address - Country:US
Mailing Address - Phone:314-839-4554
Mailing Address - Fax:314-837-0047
Practice Address - Street 1:1224 GRAHAM RD
Practice Address - Street 2:SUITE C-1330
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-8028
Practice Address - Country:US
Practice Address - Phone:314-839-4554
Practice Address - Fax:314-837-0047
Is Sole Proprietor?:No
Enumeration Date:2011-07-15
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008001043133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered