Provider Demographics
NPI:1821609561
Name:PALMER, SHELLEY (RDN)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3306 GARLAND AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23222-2643
Mailing Address - Country:US
Mailing Address - Phone:678-207-9455
Mailing Address - Fax:
Practice Address - Street 1:3306 GARLAND AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23222-2643
Practice Address - Country:US
Practice Address - Phone:678-207-9455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-15
Last Update Date:2020-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty