Provider Demographics
NPI:1245281815
Name:MASON, SHERRI ANN (RD, CDCES)
Entity type:Individual
Prefix:MS
First Name:SHERRI
Middle Name:ANN
Last Name:MASON
Suffix:
Gender:F
Credentials:RD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12300 VONN RD APT 2204
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-3412
Mailing Address - Country:US
Mailing Address - Phone:928-412-1433
Mailing Address - Fax:
Practice Address - Street 1:12300 VONN RD APT 2204
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-3412
Practice Address - Country:US
Practice Address - Phone:928-412-1433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ877907133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ109885Medicare PIN
AZ109886Medicare PIN