Provider Demographics
NPI:1003922808
Name:SHERMAN, STEPHANIE JEANNE (REGISTERED DIETITIAN)
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:JEANNE
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 DORSET RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23234-3643
Mailing Address - Country:US
Mailing Address - Phone:804-275-3294
Mailing Address - Fax:
Practice Address - Street 1:1201 BROAD ROCK BLVD
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23249
Practice Address - Country:US
Practice Address - Phone:804-675-5000
Practice Address - Fax:804-675-5667
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
685903133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered