Provider Demographics
NPI:1326412834
Name:MARSHALL, STEPHENIE JOSEPH (MS, RDN, LDN)
Entity Type:Individual
Prefix:
First Name:STEPHENIE
Middle Name:JOSEPH
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3529 MIMOSA CT
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-8304
Mailing Address - Country:US
Mailing Address - Phone:504-874-0053
Mailing Address - Fax:
Practice Address - Street 1:3529 MIMOSA CT
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70131-8304
Practice Address - Country:US
Practice Address - Phone:504-874-0053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-20
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16539133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered