Provider Demographics
NPI:1215720321
Name:ZUERCHER, JENNIFER L (PHD, RD, LDN)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L
Last Name:ZUERCHER
Suffix:
Gender:F
Credentials:PHD, RD, LDN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:STYLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1904 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-5519
Mailing Address - Country:US
Mailing Address - Phone:919-206-4332
Mailing Address - Fax:
Practice Address - Street 1:1904 MEADOW LN
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-5519
Practice Address - Country:US
Practice Address - Phone:919-206-4332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164007811133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered