Provider Demographics
NPI:1023203262
Name:MURRAY, STEPHANIE M (MS,RD CDE)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:M
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MS,RD CDE
Other - Prefix:MRS
Other - First Name:STEPHANIE
Other - Middle Name:M
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD, CDE
Mailing Address - Street 1:BELLVIEW STREET AT JEFFERSON
Mailing Address - Street 2:CRMH THIRD FLOOR SOUTH
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014
Mailing Address - Country:US
Mailing Address - Phone:540-853-0849
Mailing Address - Fax:
Practice Address - Street 1:BELLVIEW AT JEFFERSON STREET
Practice Address - Street 2:CRMH THIRD FLOOR SOUTH
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014
Practice Address - Country:US
Practice Address - Phone:540-983-0849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
VA726112133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered