Provider Demographics
NPI:1740303320
Name:KINNE, JENNY CHRISTINE (MS, RD, LDN, CLC)
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:CHRISTINE
Last Name:KINNE
Suffix:
Gender:F
Credentials:MS, RD, LDN, CLC
Other - Prefix:MISS
Other - First Name:JENNY
Other - Middle Name:CHRISTINE
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LDN, CLC
Mailing Address - Street 1:28 ELLIS AVE
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3915
Mailing Address - Country:US
Mailing Address - Phone:781-762-2881
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-6177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2466133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered