Healthcare Provider Details

I. General information

NPI: 1306935077
Provider Name (Legal Business Name): SHANNON MUHS RD, LMNT, LD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 E 1ST ST
PAPILLION NE
68046-2405
US

IV. Provider business mailing address

114 E 1ST ST
PAPILLION NE
68046-2405
US

V. Phone/Fax

Practice location:
  • Phone: 402-915-0705
  • Fax:
Mailing address:
  • Phone: 402-915-0705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number435
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number435
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: