Provider Demographics
NPI:1922271477
Name:LYNN, SHARON KIM (RD, LD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:KIM
Last Name:LYNN
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 1:6415 WINDING COVE LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-5664
Mailing Address - Country:US
Mailing Address - Phone:281-829-3903
Mailing Address - Fax:
Practice Address - Street 1:6415 WINDING COVE LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-5664
Practice Address - Country:US
Practice Address - Phone:281-829-3903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT80331133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered