Provider Demographics
NPI:1548703903
Name:SHAULIS, CHELSEA (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:SHAULIS
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 ALLISTER DR APT 114
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7266
Mailing Address - Country:US
Mailing Address - Phone:814-279-7037
Mailing Address - Fax:
Practice Address - Street 1:204 DAVIS GROVE CIR STE 103
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-2581
Practice Address - Country:US
Practice Address - Phone:919-436-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-02
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004782133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered