Provider Demographics
NPI:1134937873
Name:JOHNSON, SHERYL LYNN (FNLP)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:LYNN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:FNLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 WILLIAMS RD
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3614
Mailing Address - Country:US
Mailing Address - Phone:407-718-5476
Mailing Address - Fax:
Practice Address - Street 1:172 WILLIAMS RD
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3614
Practice Address - Country:US
Practice Address - Phone:407-718-5476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education