Provider Demographics
NPI:1164765087
Name:STEPHENS, NATALIE JOY (RD)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:JOY
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 1:872 COLLEGE PKWY APT 101
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1943
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9707 MEDICAL CENTER DR STE 200
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3361
Practice Address - Country:US
Practice Address - Phone:301-965-0546
Practice Address - Fax:301-601-7502
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1010718133V00000X
MDDX3449133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered