Provider Demographics
NPI:1336878495
Name:ZOGLMAN, JENNY LYNN (RD, LD, MHCL)
Entity Type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:LYNN
Last Name:ZOGLMAN
Suffix:
Gender:F
Credentials:RD, LD, MHCL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 LOOMIS ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN PLAIN
Mailing Address - State:KS
Mailing Address - Zip Code:67050-5003
Mailing Address - Country:US
Mailing Address - Phone:316-617-3518
Mailing Address - Fax:
Practice Address - Street 1:641 LOOMIS ST
Practice Address - Street 2:
Practice Address - City:GARDEN PLAIN
Practice Address - State:KS
Practice Address - Zip Code:67050-5003
Practice Address - Country:US
Practice Address - Phone:316-617-3518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1227133V00000X
OK1706133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered