Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JOLENE DORN, RDN
ActivePediatric Nutrition · GREEN BAY, WI
Registration Details
- NPI Number
- 1508596495
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 14, 2022 (3.8549206142248 yrs)
- Last Updated
- Oct 11, 2022
- Licenses
-
2717-29 (WI)5012-29 (WI)
Practice Information
- Address
-
1860 SHAWANO AVEGREEN BAY, WI, 543032667Browse WI providers · Browse ZIP 54303
- Phone
- 9204964700
- Primary Specialty
-
Pediatric Nutrition
133VN1004X
- Additional Specialty
- Pediatric Nutrition
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.