Provider Demographics
NPI:1841682937
Name:SHEN, YI-LING (RD)
Entity type:Individual
Prefix:
First Name:YI-LING
Middle Name:
Last Name:SHEN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:SHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:1481 W 10TH ST
Mailing Address - Street 2:NUTRITION SERVICES
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2803
Mailing Address - Country:US
Mailing Address - Phone:317-988-2808
Mailing Address - Fax:
Practice Address - Street 1:1481 W 10TH ST
Practice Address - Street 2:NUTRITION SERVICES
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2803
Practice Address - Country:US
Practice Address - Phone:317-988-2808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH86031953133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered