Healthcare Provider Details

I. General information

NPI: 1700101417
Provider Name (Legal Business Name): STEFANIE MARIE RAPP RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2010
Last Update Date: 04/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SCOTT AND WHITE HOSPITAL 2401 SOUTH 31ST STREET
TEMPLE TX
76508-0001
US

IV. Provider business mailing address

SCOTT AND WHITE HOSPITAL 2401 SOUTH 31ST STREET
TEMPLE TX
76508-0001
US

V. Phone/Fax

Practice location:
  • Phone: 254-724-6393
  • Fax: 254-724-6884
Mailing address:
  • Phone: 254-724-6393
  • Fax: 254-724-6884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License NumberDT81492
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: