Provider Demographics
NPI:1194860197
Name:STEPHNEY, CHESSICA D (RD, CDE)
Entity Type:Individual
Prefix:MRS
First Name:CHESSICA
Middle Name:D
Last Name:STEPHNEY
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 HARCOURT WAY APT 201
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-3107
Mailing Address - Country:US
Mailing Address - Phone:901-309-1830
Mailing Address - Fax:
Practice Address - Street 1:2996 KATE BOND RD STE 413
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38133-4063
Practice Address - Country:US
Practice Address - Phone:901-384-0065
Practice Address - Fax:901-266-1165
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1807133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered