Provider Demographics
NPI:1265670582
Name:ADAMS, SHERRY A (RD)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:A
Last Name:ADAMS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:G
Other - Last Name:ALLBERRY-ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:2926 S 112TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-4702
Mailing Address - Country:US
Mailing Address - Phone:402-740-9138
Mailing Address - Fax:
Practice Address - Street 1:601 N 30TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2137
Practice Address - Country:US
Practice Address - Phone:402-717-4869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-23
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE295133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE013093Medicare UPIN