NPI 1578911129 · live from the CMS NPI Registry
Jennifer Ashley
Dietitian, Registered in Decatur, IL. National Provider Identifier 1578911129, active.
NPI record
| NPI | 1578911129 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 1800 E Lake Shore Dr, Decatur, IL 62521 |
| Practice phone | 217-464-2966 |
| Mailing address | 115 W North Water St, Bethany, IL 61914 |
| Enumerated | May 24, 2016 |
| Last updated | January 1, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 164006823 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.