Provider Demographics
NPI:1801876578
Name:JEROME, DANIELLE (RD)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:JEROME
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 STEEPLECHASE CIR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1977
Mailing Address - Country:US
Mailing Address - Phone:302-598-3900
Mailing Address - Fax:
Practice Address - Street 1:232 STEEPLECHASE CIR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-1977
Practice Address - Country:US
Practice Address - Phone:302-598-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDN-0011214133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEP87066Medicare UPIN
DE011412C49Medicare PIN