| Doctor Name: | SHELLY EDENS |
| NPI Number: | 1093139677 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.D., C.S.O., L.D.N. |
| License Number: | ND 5449 |
| Business Practice Address: | 60 Memorial Medical Pkwy Food And Nutrition Department Palm Coast, FL - 321645980 |
| Business Phone Number: | 3865864320 |
| Business Fax Number: | |
| Mailing Address: | 8539 Gate Pkwy W, Unit 1435 JACKSONVILLE |
| State: | FL |
| Postal Code: | 322161019 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/18/2014 |
| NPI Last Update Date: | 02/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | ND 5449 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| 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 |