MRS. SHANNON MOONEY WICKMAN RD LDN CSOWM NPI 1356423024

NPI Information

NPI: 1356423024
Provider Name: MRS. SHANNON MOONEY WICKMAN, RD, LDN, CSOWM
Classification: Dietitian, Registered - 133VN1201X
Entity Type: Individual

Specialization: Nutrition, Obesity and Weight Management

Address:
72 MAIN ST
KENNEBUNK, ME
ZIP 04043
Phone: (207) 467-8825
Get Directions

MRS. Shannon Mooney Wickman, RD, LDN, CSOWM is a nutrition and obesity and weight management dietitian registered in Kennebunk, ME. The provider is an individual who is a Board Certified Specialist for Obesity and Weight Management and educates, supports, and advocates for patients and clients to understand and manage their weight and associated risks through the use of nutritional, behavioral health, medical, surgical, pharmacotherapeutic, and exercise and physical activity interventions. MRS. Shannon Mooney Wickman, RD, LDN, CSOWM NPI is 1356423024. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

72 MAIN ST
KENNEBUNK, ME
ZIP 04043-021
Phone: (207) 467-8825
Fax: (207) 467-8811

The enumeration date for this NPI number is 10/20/2006 and was last updated on 7/24/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	133V00000X	Dietitian, Registered		2439	MASSACHUSETTS	No
2	133VN1201X	Dietitian, Registered	Nutrition, Obesity and Weight Management	DI1082	MAINE	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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