Provider Demographics
NPI:1144936667
Name:SCHELLENBERG, PERRI (MS, RDN, LDN)
Entity type:Individual
Prefix:
First Name:PERRI
Middle Name:
Last Name:SCHELLENBERG
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10550 BAYMEADOWS RD UNIT 714
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-4548
Mailing Address - Country:US
Mailing Address - Phone:904-868-0015
Mailing Address - Fax:
Practice Address - Street 1:2585 HERSCHEL ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4557
Practice Address - Country:US
Practice Address - Phone:904-388-2678
Practice Address - Fax:904-388-6776
Is Sole Proprietor?:No
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND8713133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered