Provider Demographics
NPI:1437505542
Name:PHILLIPS, SHARON HARRIS B (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:HARRIS B
Last Name:PHILLIPS
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 1:7769 E LYONS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66441-7829
Mailing Address - Country:US
Mailing Address - Phone:931-436-8187
Mailing Address - Fax:
Practice Address - Street 1:7769 E LYONS CREEK RD
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:KS
Practice Address - Zip Code:66441-7829
Practice Address - Country:US
Practice Address - Phone:931-436-8187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-06
Last Update Date:2020-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2296133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered