Shoulders, Carol Jean

Shoulders, Carol Jean is an individual health care provider with primary practice located at Us Hwy 491 North , Shiprock NM 87420. She recently has 2 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Dietitian, Registered, Nursing Service Providers / Diabetes Educator. Dietary & Nutritional Service Providers / Dietitian, Registered is her primary health care specialty. Shoulders, Carol Jean can be contacted via phone (505) 968-6020.

Contact Information

Primary practice address
Us Hwy 491 North Shiprock NM 87420
Phone: (505) 968-6020
Fax: (505) 368-6481
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 505 New Mexico
Nursing Service Providers / Diabetes Educator 163WD0400X 09315463 New Mexico

Profile Details

NPI number 1841287182
LBN Legal business name Shoulders, Carol Jean
Credentials RD CDE LD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841287182 NPPES
New Mexico MEDICAID 17125758

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