Provider Demographics
NPI:1417591462
Name:VETTEL, SHERI RAE (MPH, RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:RAE
Last Name:VETTEL
Suffix:
Gender:F
Credentials:MPH, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 WALKER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-2319
Mailing Address - Country:US
Mailing Address - Phone:919-389-6960
Mailing Address - Fax:
Practice Address - Street 1:1608 WALKER AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-2319
Practice Address - Country:US
Practice Address - Phone:919-389-6960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-03
Last Update Date:2019-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003288133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered