Provider Demographics
NPI:1487462784
Name:CHURCHIA, SHERILYN DAWN (RDN, LDN)
Entity type:Individual
Prefix:
First Name:SHERILYN
Middle Name:DAWN
Last Name:CHURCHIA
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 E 329TH ST
Mailing Address - Street 2:
Mailing Address - City:WILLOWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44095-3306
Mailing Address - Country:US
Mailing Address - Phone:216-347-5271
Mailing Address - Fax:
Practice Address - Street 1:444 E 329TH ST
Practice Address - Street 2:
Practice Address - City:WILLOWICK
Practice Address - State:OH
Practice Address - Zip Code:44095-3306
Practice Address - Country:US
Practice Address - Phone:216-347-5271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4534133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered