Jenna P Cope, MPH, RD, LD

Individual provider Active NPI Registered Dietitian · Shiprock, NM

NPI 1407375587 · NPPES record last updated Sep 11, 2017

Key facts

NPI
1407375587
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
LD-1148 (NM)
Practice address
Hwy 491 North
P.O. Box 160
Shiprock, NM 87420
Phone
(505) 368-6001
NPI assigned
Sep 11, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Dietitian, Registered Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jennacope@tdh.allscriptsdirect.net

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X LD-1148 NM
Registered Dietitian 133V00000X LD-1148 NM Yes

Addresses

Primary practice location

Hwy 491 North
P.O. Box 160
Shiprock, NM 87420

Mailing address

Hwy 491 North
P.O. Box 160
Shiprock, NM 87420
Phone (505) 368-6001

Other names

  • Jenna P Tallaksen Former name

Other providers in Shiprock, NM

All providers in Shiprock, NM · Registered Dietitian in New Mexico

Sources for this page

Verify at the official NPI Registry.