Jenna Widman
Dietitian, Registered in Rocky River, OH. Individual provider (NPI-1).
NPI number1003531815
StatusActive
Last updated in NPPESOct 5, 2022
Details
- NPI
- 1003531815
- Entity type
- Individual (NPI-1)
- Name
- Jenna Widman
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 5, 2022
- Certification date
- Oct 5, 2022
- Last updated
- Oct 5, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | 86113322 | OH | Yes |
Practice location
1551 Prospect AveRocky River, OH 44116-1932
Phone 719-232-2087
Mailing address
1551 Prospect AveRocky River, OH 44116-1932
Other practice locations
3250 W 66th St Apt 548
Edina, MN 55435-5514
Edina, MN 55435-5514
Phone 320-309-8913
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