Provider Demographics
NPI:1528575776
Name:STEPHENS-BOGARD, KATHERINE L (MS RDN CDE RYT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:L
Last Name:STEPHENS-BOGARD
Suffix:
Gender:F
Credentials:MS RDN CDE RYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2686 PATTERSON RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8817
Mailing Address - Country:US
Mailing Address - Phone:970-298-6430
Mailing Address - Fax:
Practice Address - Street 1:2686 PATTERSON RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-8817
Practice Address - Country:US
Practice Address - Phone:970-298-6430
Practice Address - Fax:970-298-6430
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered