Provider Demographics
NPI:1932805561
Name:STOOPS, MEGHAN CLAIRE (RDN)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:CLAIRE
Last Name:STOOPS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 E 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32169-3411
Mailing Address - Country:US
Mailing Address - Phone:408-807-4716
Mailing Address - Fax:
Practice Address - Street 1:815 E 17TH AVE
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32169-3411
Practice Address - Country:US
Practice Address - Phone:408-807-4716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD005748133V00000X
FLND8472133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered