Provider Demographics
NPI:1265259295
Name:DILLMAN, JENNIFER (FNTP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:DILLMAN
Suffix:
Gender:F
Credentials:FNTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 DIETERLEN RD
Mailing Address - Street 2:
Mailing Address - City:HENRYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47126-9072
Mailing Address - Country:US
Mailing Address - Phone:502-541-4876
Mailing Address - Fax:
Practice Address - Street 1:649 DIETERLEN RD
Practice Address - Street 2:
Practice Address - City:HENRYVILLE
Practice Address - State:IN
Practice Address - Zip Code:47126-9072
Practice Address - Country:US
Practice Address - Phone:502-541-4876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist