Jennifer Diane Hopwood

Individual provider Active NPI Registered Dietitian · Berkeley, MO

NPI 1487162574 · NPPES record last updated Jan 11, 2018

Key facts

NPI
1487162574
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
2010032569 (MO)
Practice address
6121 N Hanley Rd
Berkeley, MO 63134-2003
Phone
(314) 653-0175
NPI assigned
Jan 11, 2018
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)
No

State licenses

LicenseStateTypeSpecialty
2010032569MOMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2010032569 MO Yes

Addresses

Primary practice location

6121 N Hanley Rd
Berkeley, MO 63134-2003

Mailing address

6121 N Hanley Rd
Berkeley, MO 63134-2003

Other providers in Berkeley, MO

All providers in Berkeley, MO · Registered Dietitian in Missouri

Sources for this page

Verify at the official NPI Registry.