Provider Demographics
NPI:1023554243
Name:WINCHELL, SHERRY (RD, LN)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:WINCHELL
Suffix:
Gender:F
Credentials:RD, LN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4759
Mailing Address - Country:US
Mailing Address - Phone:406-457-8912
Mailing Address - Fax:
Practice Address - Street 1:1930 9TH AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4759
Practice Address - Country:US
Practice Address - Phone:406-457-8912
Practice Address - Fax:406-457-8990
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-NUTR-LIC-41165133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered