Provider Demographics
NPI:1063023463
Name:CAIRNS, SEAN (MS)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:CAIRNS
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 S MAYS ST STE 200
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-6784
Mailing Address - Country:US
Mailing Address - Phone:737-484-0148
Mailing Address - Fax:
Practice Address - Street 1:1104 S MAYS ST STE 200
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-6784
Practice Address - Country:US
Practice Address - Phone:737-484-1048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education