Provider Demographics
NPI:1144473539
Name:ENGELMEYER, JENNIFER ROSE (RD, LMNT)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ROSE
Last Name:ENGELMEYER
Suffix:
Gender:F
Credentials:RD, LMNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:17810 WELCH PLAZA
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135
Mailing Address - Country:US
Mailing Address - Phone:402-896-4168
Mailing Address - Fax:402-861-9074
Practice Address - Street 1:17810 WELCH PLAZA
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68135
Practice Address - Country:US
Practice Address - Phone:402-896-4168
Practice Address - Fax:402-861-9074
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE795133V00000X
NE933084133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered