Provider Demographics
NPI:1366203986
Name:JENNA SCHUDER, INC
Entity type:Organization
Organization Name:JENNA SCHUDER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:MCDOUGALL
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, RDN, LD
Authorized Official - Phone:651-983-4391
Mailing Address - Street 1:2104 SARGENT AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-1125
Mailing Address - Country:US
Mailing Address - Phone:651-983-4391
Mailing Address - Fax:
Practice Address - Street 1:7201 METRO BLVD STE 550
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-1353
Practice Address - Country:US
Practice Address - Phone:612-429-1968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty