Provider Demographics
NPI:1003417841
Name:VINNOLA, JENNIFER AKIKO (DRPH, MS, RD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:AKIKO
Last Name:VINNOLA
Suffix:
Gender:
Credentials:DRPH, MS, RD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:AKIKO
Other - Last Name:WANBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DRPH, MS, RD
Mailing Address - Street 1:123 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-4227
Mailing Address - Country:US
Mailing Address - Phone:406-247-3350
Mailing Address - Fax:406-247-3389
Practice Address - Street 1:123 S 27TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-4227
Practice Address - Country:US
Practice Address - Phone:406-247-3350
Practice Address - Fax:406-247-3389
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT99702133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered