Doctor Name: | MRS. SHANNON LYN CARROLL |
NPI Number: | 1073686796 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.D. |
License Number: | 848411 |
Business Practice Address: | 2400 South St Greater Lafayette Health Services Food And Nutrition Lafayette, IN - 479043027 |
Business Phone Number: | 7654495139 |
Business Fax Number: | 7654493061 |
Mailing Address: | 7392 W Division Line Rd, DELPHI |
State: | IN |
Postal Code: | 469238909 |
Phone Number: | 7655643650 |
Fax Number: | |
NPI Enumeration Date: | 11/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 848411 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |