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General NPI Number Information
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NPI Number | 1902484975
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Entity Type | Individual
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Provider Name | SHELBY DAWN CRADIER MS, RDN, LD
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Gender | Female
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Dates
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Enumeration Date | 03/31/2021
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 750 8TH AVE STE 200
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City | FORT WORTH
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State | TX
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Zip | 76104-2500
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Country | US
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Telephone | 682-885-5945
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Fax | 817-335-8277
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Provider Business Mailing Address
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Address Line | PO BOX 733784
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City | DALLAS
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State | TX
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Zip | 75373-3784
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Country | US
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Telephone | 682-885-6483
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Fax | 682-885-3113
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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 | DT86963
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number | DT86963
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License Number State | TX
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