PENNY JEAN STADICK


Address: 20259 N Ryans Trl, Maricopa, AZ 85138-2446
Phone: 4807662716

PENNY JEAN STADICK (NPI# 1538780598) 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) 1538780598
Entity Type Individual
Full Name PENNY JEAN STADICK
Practice Address 20259 N Ryans Trl
Maricopa
AZ 85138-2446
Practice Telephone 4807662716
Mailing Telephone 4807662716
Enumeration Date 2020-04-30
Last Update Date 2020-04-30
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 133NN1002X Nutritionist
Specialization: Nutrition, Education
Dietary & Nutritional Service Providers

Office Location

Street Address 20259 N RYANS TRL
City MARICOPA
State AZ
Zip Code 85138-2446

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1972087013 Kristina Donnay Family Medicine 41600 W Smith Enke Rd Ste 3, Maricopa, AZ 85138 2018-09-24
1861909657 Four Directions LLC Respite Care 43989 W Wade Drive, Maricopa, AZ 85138 2018-01-03
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Taxonomy Information

Taxonomy Code 133NN1002X
Grouping Dietary & Nutritional Service Providers
Classification Nutritionist
Specialization Nutrition, Education

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
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1881219707 Gabrielle Hungate Nutritionist 10754 N Chapin Ct, Tucson, AZ 85737-6634 2020-06-16
1275099020 David Medansky Nutritionist 11980 W Shifting Sands Dr, Peoria, AZ 85383-2623 2019-02-18
1306345780 Christine Inez Cintron Nutritionist 9231 E Carol Ave, Mesa, AZ 85208-2497 2018-02-12
1285143115 Charles Higgins Jr. Nutritionist 600 N 4th St Apt 272, Phoenix, AZ 85004-4485 2017-09-22
1326568486 Damian Dube Nutritionist 1503 N Rockwell St, Gilbert, AZ 85234-1436 2017-06-20
1427593391 Martha Imelda Huizar Nutritionist 2214 E Vera Cruz Vis, Tucson, AZ 85713-5199 2016-12-30
1639622434 Jenny Woelk Nutritionist 2757 S Pewter Dr, 102, Gilbert, AZ 85295-1282 2016-07-27
1356790158 Banner Umc Dpec Nutritionist 3950 S Country Club Road, Suite 130, Tucson, AZ 85714 2016-06-13
1053783829 Debra L Mcdaniel-perez Nutritionist 28784 E Aster Ln, Marana, AZ 85658-9223 2015-10-20
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Competitor

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City MARICOPA
Zip Code 85138

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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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