Provider Demographics
NPI:1558684399
Name:GEDEON, JEANNIE (MPH, RD, CEDS, CAP)
Entity type:Individual
Prefix:
First Name:JEANNIE
Middle Name:
Last Name:GEDEON
Suffix:
Gender:F
Credentials:MPH, RD, CEDS, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 S PALMWAY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-4637
Mailing Address - Country:US
Mailing Address - Phone:561-569-1945
Mailing Address - Fax:
Practice Address - Street 1:522 S PALMWAY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH BEACH
Practice Address - State:FL
Practice Address - Zip Code:33460-4637
Practice Address - Country:US
Practice Address - Phone:561-569-1945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2025-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND8227133N00000X
817257133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist