CICELY SHANKLE (NPI# 1396302519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396302519 |
| Entity Type | Individual |
| Full Name | CICELY SHANKLE |
| Practice Address |
1897 Rj Loop Fairbanks AK 99709-4145 |
| Practice Telephone | 9073226262 |
| Mailing Telephone | 9073226262 |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2020-03-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133N00000X | Nutritionist | 146810 | AK | Dietary & Nutritional Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3039 Davis Rd, Fairbanks, AK 997095234 | 9074523600 |
| Street Address |
1897 RJ LOOP |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99709-4145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255946810 | Beacon Monitoring Professional Services | Technician, Other | 745 Staffordshire Rd, Fairbanks, AK 99709 | 2020-09-10 |
| 1235629544 | Fairbanks Healing Space | Health Educator | 3875 Geist Road, Suite E #136, Fairbanks, AK 99709 | 2018-05-11 |
| 1609395409 | Shawn K Goggins | Counselor | 1423 Peger Road, Fairbanks, AK 99709 | 2017-09-12 |
| 1710433347 | Jay Titus | Technician/Technologist | 2884 Marina Drive, Fairbanks, AK 99709 | 2016-09-01 |
| 1710391610 | Hannah Summerfelt | Dentist | 3539 Thomas St, Fairbanks, AK 99709 | 2014-06-18 |
| 1629407325 | Diane Louise Mitchell | Nurse Practitioner | 4650 Harvard Cir, Fairbanks, AK 99709 | 2013-11-04 |
| 1407147929 | Christina Martz | Counselor | 1270 Summet Drive, Fairbanks, AK 99709 | 2011-05-02 |
| 1255652285 | Surgery Center of Fairbanks LLC | Clinic/Center | 2310 Peger Road, Fairbanks, AK 99709 | 2010-06-14 |
| 1962661835 | John Leo Hughes Jr Jr. | Dentist | 3437 Airport Way, Suite 205, Fairbanks, AL 99709 | 2008-06-05 |
| 1508042417 | Katherine E Johnson, Md PC | Ophthalmology | 2485 Chief William Drive, Suite 100, Fairbanks, AK 99709 | 2008-01-10 |
| Find all providers in zip 99709 | ||||
| Taxonomy Code | 133N00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Nutritionist |
| A specialist in adapting and applying food and nutrient knowledge to the solution of food and nutritional problems, the control of disease, and the promotion of health. Nutritionists perform research, instruct groups and individuals about nutritional requirements, and assist people in developing meal patterns that meet their nutritional needs; (2) A nutritionist is someone who has completed undergraduate and/or graduate training in the discipline of nutrition without necessarily meeting the academic and experience requirements to qualify for the Registered Dietitian designation. |
| Notes: Source: (1) Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528341781 | Ellen Mareen Olson | Nutritionist | 2295 Stevens Ave, Fairbanks, AK 99709-6284 | 2011-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881062354 | Brisa Alegria | Nutritionist | 1001 W Adson Rd, Wasilla, AK 99654-8723 | 2015-09-14 |
| 1841504883 | Stephanie Ann Figon | Nutritionist | 2030 South Killarney Drive, Palmer, AK 99645 | 2010-08-02 |
| 1740846807 | Dopanine LLC | Nutritionist | 3161 E Palmer Wasilla Hwy Ste 1c, Wasilla, AK 99654-7271 | 2019-05-14 |
| 1235792177 | Alexa Breanne Pullen | Nutritionist | 3161 E Palmer Wasilla Hwy Ste 1c, Wasilla, AK 99654-7271 | 2019-04-16 |
| 1700245222 | Suanne Faith Sikkema | Nutritionist | 610 W 2nd Ave, Suite 100, Anchorage, AK 99501-2151 | 2016-02-11 |
| 1225276777 | Minette Sue Ridenour Herrick | Nutritionist | 673d Mdg, 5955 Zeamer Avenue, Anchorage, AK 99506 | 2009-01-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.