Provider Demographics
NPI:1558159681
Name:BARNUM, JENNIFER (RDN, LD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BARNUM
Suffix:
Gender:
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8933 BELCONTE LN
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-6916
Mailing Address - Country:US
Mailing Address - Phone:702-416-5011
Mailing Address - Fax:
Practice Address - Street 1:8933 BELCONTE LN
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-6916
Practice Address - Country:US
Practice Address - Phone:702-416-5011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered