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General NPI Number Information
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NPI Number | 1750040242
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Entity Type | Individual
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Provider Name | RACE R SHEPHERD MS, RD, LD
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Gender | Male
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Dates
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Enumeration Date | 12/11/2021
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 2000 OLATHE FL 5
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City | KANSAS CITY
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State | KS
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Zip | 66160-8505
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Country | US
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Telephone | 913-588-6022
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Fax |
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Provider Business Mailing Address
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Address Line | 12490 QUIVIRA RD APT 3524
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City | OVERLAND PARK
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State | KS
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Zip | 66213-2458
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Country | US
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Telephone |
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Fax |
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 86292947
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License Number State | KS
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