Provider Demographics
NPI:1265243109
Name:YOUR DIABETES DIETITIAN
Entity type:Organization
Organization Name:YOUR DIABETES DIETITIAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOSKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, CDCES
Authorized Official - Phone:402-690-8461
Mailing Address - Street 1:820 N 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NE
Mailing Address - Zip Code:68059-5739
Mailing Address - Country:US
Mailing Address - Phone:402-690-8461
Mailing Address - Fax:
Practice Address - Street 1:820 N 10TH AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NE
Practice Address - Zip Code:68059-5739
Practice Address - Country:US
Practice Address - Phone:402-690-8461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty