Provider Demographics
NPI:1265499362
Name:STEPHENS, NATALIE MARIE (RD)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:MARIE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:MARIE
Other - Last Name:DENNISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1492 EAST BROAD STREET
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205
Mailing Address - Country:US
Mailing Address - Phone:614-293-2300
Mailing Address - Fax:614-293-3740
Practice Address - Street 1:1492 EAST BROAD STREET
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205
Practice Address - Country:US
Practice Address - Phone:614-293-2300
Practice Address - Fax:614-293-3740
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEMT02851Medicare ID - Type Unspecified