Provider Demographics
NPI:1154465219
Name:STIMSON, CHERYL (RD)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:
Last Name:STIMSON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 H AVE
Mailing Address - Street 2:
Mailing Address - City:KALONA
Mailing Address - State:IA
Mailing Address - Zip Code:52247-9704
Mailing Address - Country:US
Mailing Address - Phone:319-356-1414
Mailing Address - Fax:319-384-9393
Practice Address - Street 1:100 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1011
Practice Address - Country:US
Practice Address - Phone:319-356-1414
Practice Address - Fax:319-384-9393
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00810133VN1004X, 133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
Not Answered133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic