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Individual
MRS. JEANICE A. SHIMON
Active
Individual
MRS. JEANICE A. SHIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD,LD
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
230
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000030
BLUE CROSS
KS
01
—
014013
BLUE SHIELD
KS
05
—
100005090A
—
KS
01
—
486005089
COMMERCIAL
KS
Enumeration date
09/14/2006
Last updated
06/24/2013
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