Jennifer Lynn Deblois, RDN

Individual provider Active NPI Registered Dietitian · North Providence, RI

NPI 1093285751 · NPPES record last updated Nov 26, 2018

Key facts

NPI
1093285751
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
LDN00979 (RI)
Practice address
200 High Service Ave
North Providence, RI 02904-5113
NPI assigned
Nov 26, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
LDN00979RIMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LDN00979 RI Yes

Addresses

Primary practice location

200 High Service Ave
North Providence, RI 02904-5113

Mailing address

17 Hunters KNL
Smithfield, RI 02917-2569
Phone (401) 258-3076

Other providers in North Providence, RI

All providers in North Providence, RI · Registered Dietitian in Rhode Island

Sources for this page

Verify at the official NPI Registry.