Provider Demographics
NPI:1770838500
Name:EBERLE, SHELLEY GAIL (RD, CSO, LDN)
Entity Type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:GAIL
Last Name:EBERLE
Suffix:
Gender:F
Credentials:RD, CSO, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 MARLBORO DR
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-4934
Mailing Address - Country:US
Mailing Address - Phone:724-989-0438
Mailing Address - Fax:
Practice Address - Street 1:5115 CENTRE AVE
Practice Address - Street 2:3RD FLOOR COOPER PAVILION
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1301
Practice Address - Country:US
Practice Address - Phone:412-864-7500
Practice Address - Fax:412-623-2429
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003018133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered