Provider Demographics
NPI:1245571496
Name:STORBAKKEN, SHEILA MARIE (RD,LD)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:MARIE
Last Name:STORBAKKEN
Suffix:
Gender:F
Credentials:RD,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1989 PARK ST
Mailing Address - Street 2:
Mailing Address - City:SHELDON
Mailing Address - State:IA
Mailing Address - Zip Code:51201-8535
Mailing Address - Country:US
Mailing Address - Phone:712-324-2561
Mailing Address - Fax:
Practice Address - Street 1:1989 PARK ST
Practice Address - Street 2:
Practice Address - City:SHELDON
Practice Address - State:IA
Practice Address - Zip Code:51201-8535
Practice Address - Country:US
Practice Address - Phone:712-324-2561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered