Provider Demographics
NPI:1255105151
Name:STINSON, WENDY BOUNDS (PHD, RD)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:BOUNDS
Last Name:STINSON
Suffix:
Gender:F
Credentials:PHD, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 BONNE TERRE DR
Mailing Address - Street 2:
Mailing Address - City:EADS
Mailing Address - State:TN
Mailing Address - Zip Code:38028-3340
Mailing Address - Country:US
Mailing Address - Phone:901-484-5485
Mailing Address - Fax:
Practice Address - Street 1:315 S WALNUT BEND RD
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-1508
Practice Address - Country:US
Practice Address - Phone:901-755-8880
Practice Address - Fax:855-279-6742
Is Sole Proprietor?:No
Enumeration Date:2023-11-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2133133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered