Provider Demographics
NPI:1932655362
Name:SHERWIN, ABIGAIL LEIGH
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:LEIGH
Last Name:SHERWIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30161
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48909-7661
Mailing Address - Country:US
Mailing Address - Phone:517-887-4480
Mailing Address - Fax:517-887-4384
Practice Address - Street 1:5303 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-3800
Practice Address - Country:US
Practice Address - Phone:517-887-4480
Practice Address - Fax:517-887-4384
Is Sole Proprietor?:No
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered