Healthcare Provider Details

I. General information

NPI: 1790275352
Provider Name (Legal Business Name): SHEILAH HEBERT MS, RD, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2018
Last Update Date: 05/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

446 W CIRCLE DR
EAST LANSING MI
48824-3704
US

IV. Provider business mailing address

446 W CIRCLE DR
EAST LANSING MI
48824-3704
US

V. Phone/Fax

Practice location:
  • Phone: 517-432-3076
  • Fax:
Mailing address:
  • Phone: 517-432-3076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-20319
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number898896
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: