Provider Demographics
NPI:1245400423
Name:DENDY, STEFANIE PATTERSON (RPA/RRA)
Entity type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:PATTERSON
Last Name:DENDY
Suffix:
Gender:F
Credentials:RPA/RRA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 GRAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:YAZOO CITY
Mailing Address - State:MS
Mailing Address - Zip Code:39194
Mailing Address - Country:US
Mailing Address - Phone:662-751-8164
Mailing Address - Fax:662-751-8287
Practice Address - Street 1:825 GRAND AVENUE
Practice Address - Street 2:
Practice Address - City:YAZOO CITY
Practice Address - State:MS
Practice Address - Zip Code:39194
Practice Address - Country:US
Practice Address - Phone:662-751-8164
Practice Address - Fax:662-751-8287
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSMRT1839282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural