Provider Demographics
NPI:1609290089
Name:JONSSON, SHERI (MS, RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:
Last Name:JONSSON
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 AYLWARD AVE
Mailing Address - Street 2:PO BOX 87
Mailing Address - City:ELLSWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:67439-2541
Mailing Address - Country:US
Mailing Address - Phone:785-472-3111
Mailing Address - Fax:785-472-5639
Practice Address - Street 1:1604 AYLWARD AVE
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:KS
Practice Address - Zip Code:67439-2541
Practice Address - Country:US
Practice Address - Phone:785-472-3111
Practice Address - Fax:785-472-5639
Is Sole Proprietor?:No
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1391133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered