Provider Demographics
NPI:1487862892
Name:BENNE-ADKINS, STELLA M (MNS,RD,CDE)
Entity Type:Individual
Prefix:MS
First Name:STELLA
Middle Name:M
Last Name:BENNE-ADKINS
Suffix:
Gender:F
Credentials:MNS,RD,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 FAIRBROOK DR
Mailing Address - Street 2:
Mailing Address - City:BORDENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08505-4800
Mailing Address - Country:US
Mailing Address - Phone:609-499-7086
Mailing Address - Fax:609-499-7086
Practice Address - Street 1:146 FAIRBROOK DR
Practice Address - Street 2:
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505-4800
Practice Address - Country:US
Practice Address - Phone:609-499-7086
Practice Address - Fax:609-499-7086
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1015079Medicare UPIN
NJ301257Medicare UPIN
NJ9462532002Medicare UPIN
NJ055713Medicare ID - Type Unspecified