Provider Demographics
NPI:1538245576
Name:COLLIER, SHERRY P (RD, LD/N)
Entity type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:P
Last Name:COLLIER
Suffix:
Gender:F
Credentials:RD, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 BAYBERRY PL
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7703
Mailing Address - Country:US
Mailing Address - Phone:561-801-5712
Mailing Address - Fax:
Practice Address - Street 1:3501 WILLOUGHBY BLVD.
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997
Practice Address - Country:US
Practice Address - Phone:772-288-0304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 4849133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLND 4849OtherDIETITIAN/NUTRITIONIST