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General NPI Number Information
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NPI Number | 1558627620
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Entity Type | Individual
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Provider Name | SHARON LOUISE ERNST RD, CSP
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Gender | Female
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Dates
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Enumeration Date | 04/03/2012
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 100 MARIO CAPECCHI DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84113-1103
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Country | US
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Telephone | 801-662-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 50 N MARIO CAPECCHI DR RM 2C412, SOM
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City | SALT LAKE CITY
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State | UT
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Zip | 84132-0001
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Country | US
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Telephone | 801-581-8738
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Fax | 801-587-7690
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number | 501004
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 1057704901
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License Number State | UT
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