STEPHANIE LYNN HENDERSON


Address: 1555 Vernon Ave, Blackfoot, ID 83221
Phone: 3073990139

STEPHANIE LYNN HENDERSON (NPI# 1528373313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1528373313
Entity Type Individual
Full Name STEPHANIE LYNN HENDERSON
Credential RD LD
Practice Address 1555 Vernon Ave
Blackfoot
ID 83221
Mailing Address 1555 Vernon Ave
Blackfoot
ID 83221-3050
Practice Telephone 3073990139
Mailing Telephone 3073990139
Enumeration Date 2010-08-17
Last Update Date 2011-07-07
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 133V00000X Dietitian, Registered D-629 ID Dietary & Nutritional Service Providers

Other Providers STEPHANIE HENDERSON

NPI Name Taxonomy Address Enumeration
1093325581 Stephanie Henderson Social Worker 301 England St # 485, Ashland, VA 23005-2109 2020-08-09
1518496520 Stephanie Leigh Henderson Speech-Language Pathologist 9990 Richmond Ave Ste 201s, Houston, TX 77042-4559 2017-06-05
1699318329 Stephanie Danielle Henderson Nurse Practitioner 5113 Wayland Dr, Odessa, TX 79762-5520 2019-10-25
1861968810 Stephanie Henderson Physician Assistant 445 Harlow Rd Ste 200, Springfield, OR 97477-1341 2018-10-17
1639678857 Stephanie Henderson Case Manager/Care Coordinator 38882 Mentor Ave, Willoughby, OH 44094-7875 2018-02-02
1750836540 Stephanie Henderson Counselor 175 Gwinnett Dr, Lawrenceville, GA 30046-8444 2016-08-22
1982073243 Stephanie Deshae Henderson Social Worker 4500 S Lancaster Rd, Dallas, TX 75216-7167 2015-09-16
1417388463 Stephanie Michelle Renea Henderson Counselor 224 Great Bridge Blvd, Chesapeake, VA 23320-3904 2013-12-02
1235490293 Stephanie Ann Henderson Dentist 5053 Tuttle Crossing Blvd, Dublin, OH 43016-1533 2012-06-06
1982997284 Stephanie Diane Henderson Obstetrics & Gynecology 348 E 4500 S Ste 200, Salt Lake City, UT 84107 2011-05-18

Office Location

Street Address 1555 VERNON AVE
City BLACKFOOT
State ID
Zip Code 83221

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932711165 Samantha Paige Averett Social Worker 60 N Broadway, Blackfoot, ID 83221 2020-08-19
1730711656 Sara Marie Letham Family Medicine 33 S Thompson Lane, Blackfoot, ID 83221 2020-02-08
1962994962 Tyler Thomas Wood Student in an Organized Health Care Education/Training Program 98 Poplar Street, Blackfoot, Id 83221, Blackfoot, ID 83221 2018-06-05
1801336276 Bmh, Inc. Internal Medicine 235 Poplar St, Blackfoot, ID 83221 2017-03-03
1497119804 Susan Doran Social Worker 720 E. Alice, Blackfoot, ID 83221 2016-04-12
1427412121 Josie Russell Adkins Counselor 720 East Alice, Blackfoot, ID 83221 2016-04-08
1740590314 Ashley Nichole Thomas Physician Assistant 710 E. Alice Street, Blackfoot, ID 83221 2010-10-18
1184850141 Joy H. Taylor Nurse Practitioner 1441 Parkway Drive, Blackfoot, ID 83221 2009-06-04
1427232925 Nathan E. Sneddon Anesthesiology 98 Poplar St Fl 3, Blackfoot, ID 83221 2007-12-20
1083809289 Renal Treatment Centers West Inc Clinic/Center 1491 Parkway Drive, Blackfoot, ID 83221 2007-09-11
Find all providers in zip 83221

Taxonomy Information

Taxonomy Code 133V00000X
Grouping Dietary & Nutritional Service Providers
Classification Dietitian, Registered

Taxonomy Definition

A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration.
Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1770111924 Kywnynn Madsen Dietitian, Registered 98 Poplar St, Blackfoot, ID 83221-1758 2020-03-31
1730563248 Allison Marotz Dietitian, Registered 98 Poplar St, Blackfoot, ID 83221-1758 2015-07-14
1407277940 Shawna Durbin Dietitian, Registered 98 Poplar St, Blackfoot, ID 83221-1758 2013-12-31
1629380654 Camile Michaelson Dietitian, Registered 98 Poplar St, Blackfoot, ID 83221-1758 2010-07-07
1346552486 Jan Williamson Dietitian, Registered 98 Poplar St, Blackfoot, ID 83221-1758 2010-07-06
1891006102 Kathy Puckett Dietitian, Registered 98 Poplar St, Blackfoot, ID 83221-1758 2010-07-01

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1689272965 Katelyn Diane John Dietitian, Registered 967 N Clithero Dr, Boise, ID 83703-5703 2020-10-09
1942816871 Vanessa Yvonne Engle Dietitian, Registered 1095 S Stateline Rd, Driggs, ID 83422-4727 2020-09-16
1992310148 Ellie Rock Dietitian, Registered 5424 N Sun Shimmer Ave, Meridian, ID 83646-5536 2020-09-14
1831703057 Hydee Flishaw Tubbs Becker Dietitian, Registered 614 North Hayes Street, Moscow, ID 83843 2020-09-04
1639781743 Anna Speegle Dietitian, Registered 427 Meadowview Ln, Twin Falls, ID 83301-6883 2020-08-19
1477179646 Kayla Lynne Johnson Dietitian, Registered 570 Cobra Ct, Twin Falls, ID 83301-5694 2020-06-23
1245855113 Megan Jensen Dietitian, Registered 6929 W Trail Dr, Boise, ID 83704-4568 2020-06-16
1063035004 Chrisann M Hinson Dietitian, Registered 4716 W Quaker Ridge Dr, Meridian, ID 83646-5042 2020-05-26
1609497551 Aaron Robert Calvano Dietitian, Registered 5350 N Moose Creek Ave, Meridian, ID 83646-3639 2020-05-01
1437779469 Nutrition Dejunked LLC Dietitian, Registered 3350 W Americana Ter Ste 215, Boise, ID 83706-2545 2020-04-20
Find all providers with the same taxonomy

Competitor

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City BLACKFOOT
Zip Code 83221

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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