Provider Demographics
NPI:1457919227
Name:MAIER, JANNE HOLMBERG (RDN)
Entity Type:Individual
Prefix:
First Name:JANNE
Middle Name:HOLMBERG
Last Name:MAIER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 CUSHMAN ST STE 3H
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-4665
Mailing Address - Country:US
Mailing Address - Phone:907-322-6602
Mailing Address - Fax:
Practice Address - Street 1:250 CUSHMAN ST STE 3H
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4665
Practice Address - Country:US
Practice Address - Phone:907-322-6602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-05
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered