Provider Demographics
NPI:1669998456
Name:ROBERTS, SHERRY PATRICIA (RD, CDE)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:PATRICIA
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:PATRICIA
Other - Last Name:VANCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD,CDE
Mailing Address - Street 1:234 CROOKED CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-8505
Mailing Address - Country:US
Mailing Address - Phone:919-385-3000
Mailing Address - Fax:
Practice Address - Street 1:68 HARRISON AVE STE 605
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1929
Practice Address - Country:US
Practice Address - Phone:888-404-4813
Practice Address - Fax:888-675-4061
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA129973133V00000X
FLND13877133V00000X
LA3923133V00000X
MEDI2064133V00000X
DEDN-0011277133V00000X
ALOLYMPIA133V00000X
MO2020001221133V00000X
VT074.0134640133V00000X
MSD-2673133V00000X
NCL005047133V00000X
NH1962133V00000X
UT14195813-4901133V00000X
SC3174133V00000X
875729133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered