Provider Demographics
NPI:1265415756
Name:GARNER LINK, SHELIA C (MS RD LDN CDE)
Entity type:Individual
Prefix:MRS
First Name:SHELIA
Middle Name:C
Last Name:GARNER LINK
Suffix:
Gender:F
Credentials:MS RD LDN CDE
Other - Prefix:MISS
Other - First Name:SHELIA
Other - Middle Name:CAROLINE
Other - Last Name:GARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS RD LDN CDE
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28570-0160
Mailing Address - Country:US
Mailing Address - Phone:252-223-3914
Mailing Address - Fax:252-223-3905
Practice Address - Street 1:361B HOWARD BLVD
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:NC
Practice Address - Zip Code:28570-0160
Practice Address - Country:US
Practice Address - Phone:252-223-3914
Practice Address - Fax:252-223-3905
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-29
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL000333133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
P67212Medicare UPIN
2992064Medicare ID - Type Unspecified