Provider Demographics
NPI:1477217859
Name:JAMES, SIERRA DAWN (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:SIERRA
Middle Name:DAWN
Last Name:JAMES
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:MISS
Other - First Name:SIERRA
Other - Middle Name:DAWN
Other - Last Name:FONOROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:2143 FAIRWAY VILLAS LN S
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32233-4421
Mailing Address - Country:US
Mailing Address - Phone:352-215-0117
Mailing Address - Fax:
Practice Address - Street 1:2143 FAIRWAY VILLAS LN S
Practice Address - Street 2:
Practice Address - City:ATLANTIC BEACH
Practice Address - State:FL
Practice Address - Zip Code:32233-4421
Practice Address - Country:US
Practice Address - Phone:352-215-0117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND7110133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered