Provider Demographics
NPI:1669355889
Name:SINCLAIR, ELLEN JEANETTE (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:JEANETTE
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15382 ELIZABETH DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77705-1167
Mailing Address - Country:US
Mailing Address - Phone:563-505-0600
Mailing Address - Fax:
Practice Address - Street 1:15382 ELIZABETH DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77705-1167
Practice Address - Country:US
Practice Address - Phone:563-505-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-26
Last Update Date:2025-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT83801133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered