Basic Information
Provider Information
NPI: 1700091683
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: BARBARA
MiddleName: ANN
NamePrefix: MRS.
NameSuffix:  
Credential: R.D., L.D., M.S.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1137 OLIVAIRE LN
Address2:  
City: OLIVETTE
State: MO
PostalCode: 631323010
CountryCode: US
TelephoneNumber: 3149930793
FaxNumber:  
Practice Location
Address1: 232 S WOODS MILL RD
Address2: FOOD & NUTRITION SERVICES
City: CHESTERFIELD
State: MO
PostalCode: 630173417
CountryCode: US
TelephoneNumber: 3144341500
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/13/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
133V00000X2001005228MOY Dietary & Nutritional Service ProvidersDietitian, Registered 

No ID Information.


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