Provider Demographics
NPI:1801684592
Name:LOFTON, STACY (MS, RD)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:LOFTON
Suffix:
Gender:
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10261 RAVENCLAW DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80924-5321
Mailing Address - Country:US
Mailing Address - Phone:360-609-0076
Mailing Address - Fax:
Practice Address - Street 1:10261 RAVENCLAW DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80924-5321
Practice Address - Country:US
Practice Address - Phone:360-609-0076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
846153133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered