Provider Demographics
NPI:1639228372
Name:CARLEY, SHELLEY LYNNE (RD)
Entity Type:Individual
Prefix:MS
First Name:SHELLEY
Middle Name:LYNNE
Last Name:CARLEY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9048 SUGAR ESTATE
Mailing Address - Street 2:NUTRITION SERVICES
Mailing Address - City:ST. THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-4001
Mailing Address - Country:US
Mailing Address - Phone:340-776-8311
Mailing Address - Fax:340-714-6312
Practice Address - Street 1:9048 SUGAR ESTATE
Practice Address - Street 2:
Practice Address - City:ST. THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-4001
Practice Address - Country:US
Practice Address - Phone:340-776-8311
Practice Address - Fax:340-714-6312
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
498198133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered