Healthcare Provider Details

I. General information

NPI: 1265670582
Provider Name (Legal Business Name): SHERRY A ADAMS RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARON G ALLBERRY-ADAMS RD

II. Dates (important events)

Enumeration Date: 01/23/2009
Last Update Date: 08/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N 30TH ST
OMAHA NE
68131-2137
US

IV. Provider business mailing address

2926 S 112TH ST
OMAHA NE
68144-4702
US

V. Phone/Fax

Practice location:
  • Phone: 402-717-4869
  • Fax:
Mailing address:
  • Phone: 402-740-9138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number295
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: