NPI 1184509721 · live from the CMS NPI Registry
The Fulfilled Fork, LLC
Dietitian, Registered in Sheridan, WY. National Provider Identifier 1184509721, active.
NPI record
| NPI | 1184509721 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 1309 Coffeen Ave Ste 5655, Sheridan, WY 82801 |
| Practice phone | 307-381-0662 |
| Enumerated | August 11, 2025 |
| Last updated | August 11, 2025 |
| Authorized official | Haley Schroth, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.