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Contact Information

SHERIDAN PEAK WELLNESS
740 S. THURMOND ST.
SHERIDAN, WY82801
 Phone: 307-683-6874
 Fax: 415-559-4790
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
 

Nutrition, Education

133NN1002X
 

Nutrition, Metabolic

133VN1006X 71 Registered Dietitian or Nutrition Professional
 

Nutrition, Pediatric

133VN1004X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for SHERIDAN PEAK WELLNESS

NPI # 1053805382
LBN Legal business name SHERIDAN PEAK WELLNESS
Authorized official JENNIFER CLARK - (CORPORATION OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/20/2018
Last updated 06/20/2018 - About 8 years ago
Identifiers
WY License # 232
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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