Provider Demographics
NPI:1689859365
Name:SCHELL, DIANA G (RD, LD)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:G
Last Name:SCHELL
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 1:6501 GREENBRIAR FARMS RD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-6940
Mailing Address - Country:US
Mailing Address - Phone:239-478-0992
Mailing Address - Fax:
Practice Address - Street 1:6501 GREENBRIAR FARMS RD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-6940
Practice Address - Country:US
Practice Address - Phone:239-478-0992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM548133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered