Individual
JILL SUZANNE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, RD, LDN
Contact information
Practice address
912 N ELM ST, GREENSBORO, NC 27401-1513
(336) 455-2358
Mailing address
8109 MOORES MILL CT, STOKESDALE, NC 27357-9484
(336) 613-1347
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
916193
—
Other
Enumeration date
03/02/2021
Last updated
03/02/2021
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