Provider Demographics
NPI:1316172521
Name:PRIOR, SHELLEY RAE (MS, RD)
Entity type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:RAE
Last Name:PRIOR
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:MS
Other - First Name:SHELLEY
Other - Middle Name:RAE
Other - Last Name:ASPEVIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1800 JAMISON CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-6368
Mailing Address - Country:US
Mailing Address - Phone:970-691-5423
Mailing Address - Fax:
Practice Address - Street 1:1113 N CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-4722
Practice Address - Country:US
Practice Address - Phone:970-691-5423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
00956001133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered