Provider Demographics
NPI:1770377103
Name:HASTINGS, JENNIFER R (MS, MPH, RDN, LDN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:HASTINGS
Suffix:
Gender:
Credentials:MS, MPH, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 FAYETTEVILLE ST # 1002
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2324
Mailing Address - Country:US
Mailing Address - Phone:919-525-1735
Mailing Address - Fax:
Practice Address - Street 1:205 MAYWOOD WAY
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-3423
Practice Address - Country:US
Practice Address - Phone:919-525-1735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL008295133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered