Provider Demographics
NPI:1306935077
Name:MUHS, SHANNON (RD, LMNT)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:MUHS
Suffix:
Gender:F
Credentials:RD, LMNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11650 S 73RD ST
Mailing Address - Street 2:HY-VEE, INC.
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-1500
Mailing Address - Country:US
Mailing Address - Phone:402-597-5790
Mailing Address - Fax:402-339-4596
Practice Address - Street 1:11650 S 73RD ST
Practice Address - Street 2:HY-VEE, INC.
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-1500
Practice Address - Country:US
Practice Address - Phone:402-597-5790
Practice Address - Fax:402-339-4596
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE435133NN1002X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE278439Medicare ID - Type Unspecified