Healthcare Provider Details

I. General information

NPI: 1508716028
Provider Name (Legal Business Name): REBECCA NICOLE STONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10603 RAMEY RD
MARSHALL VA
20115-2746
US

IV. Provider business mailing address

10603 RAMEY RD
MARSHALL VA
20115-2746
US

V. Phone/Fax

Practice location:
  • Phone: 703-927-2169
  • Fax:
Mailing address:
  • Phone: 703-927-2169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number5910
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL009371
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN-0011496
License Number StateDE
# 5
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number3272
License Number StateCT
# 6
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLRD2077
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: