Provider Demographics
NPI:1083910756
Name:STEPHENS, REBECCA LEEANN (RD)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LEEANN
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8197 N IRON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-1434
Mailing Address - Country:US
Mailing Address - Phone:520-954-1142
Mailing Address - Fax:520-578-9064
Practice Address - Street 1:1631 WEST INA ROAD, SUITE 111
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704
Practice Address - Country:US
Practice Address - Phone:520-498-0359
Practice Address - Fax:520-498-0204
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered