Doctor Name: | SHANNA K CARR |
NPI Number: | 1386730232 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICENSED DIETICIAN |
License Number: | 2001000001 |
Business Practice Address: | 2725 N Westwood Blvd Ste 17 Poplar Bluff, MO - 639012367 |
Business Phone Number: | 5737789348 |
Business Fax Number: | 5736864870 |
Mailing Address: | 2725 N Westwood Blvd Ste 17, POPLAR BLUFF |
State: | MO |
Postal Code: | 639012367 |
Phone Number: | 5737789348 |
Fax Number: | 5736864870 |
NPI Enumeration Date: | 10/05/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 2001000001 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
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 |