Provider Demographics
NPI:1780920132
Name:MCDONALD, JENNIFER PATRICIA (RD,LD, CDE)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:PATRICIA
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:RD,LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 5TH AVE E
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-4377
Mailing Address - Country:US
Mailing Address - Phone:828-692-4289
Mailing Address - Fax:
Practice Address - Street 1:2579 CHIMNEY ROCK RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-9181
Practice Address - Country:US
Practice Address - Phone:828-692-4289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-12
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004964133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered