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NPI Code Detail

MEDICARE: ANGELA STEVENSON MPH, RD, LMNT

MEDICARE: ANGELA STEVENSON MPH, RD, LMNT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian1109NE

General Provider Information

NPI Number : 1447670690
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA STEVENSON MPH, RD, LMNT
Provider Business Mailing Address
First Line : 8809 W CENTER RD
Second Line :
City : OMAHA
State : NE
Zip : 68124-2044
Country : US
Telephone Number : 402-384-9072
Fax Number :
Provider Business Practice Location Address
First Line : 8809 W CENTER RD
Second Line :
City : OMAHA
State : NE
Zip : 68124-2044
Country : US
Telephone Number : 402-384-9072
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2014
Last Update Date : 04/25/2014

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