Healthcare Provider Details

I. General information

NPI: 1023063815
Provider Name (Legal Business Name): SHARON A SCHLOEGEL CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 3RD ST SE
JAMESTOWN ND
58401-4247
US

IV. Provider business mailing address

401 3RD ST SE
JAMESTOWN ND
58401-4247
US

V. Phone/Fax

Practice location:
  • Phone: 701-253-5300
  • Fax: 701-253-5402
Mailing address:
  • Phone: 701-253-5300
  • Fax: 701-253-5402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License NumberR26678
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: