Healthcare Provider Details

I. General information

NPI: 1972955789
Provider Name (Legal Business Name): STEPHANIE GARVER MS, RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2016
Last Update Date: 07/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 GILLHAM RD NUTRITION SERVICES DEPARTMENT
KANSAS CITY MO
64108-4619
US

IV. Provider business mailing address

2121 CENTRAL ST APT 412
KANSAS CITY MO
64108-2067
US

V. Phone/Fax

Practice location:
  • Phone: 816-234-3198
  • Fax:
Mailing address:
  • Phone: 913-568-8820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number2015002798
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number2002
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: