Provider Demographics
NPI:1952363459
Name:STANFIELD, STEPHANIE J (RD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:J
Last Name:STANFIELD
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 JACKSON GIMNICK LOOP
Mailing Address - Street 2:
Mailing Address - City:RAGLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70657-6506
Mailing Address - Country:US
Mailing Address - Phone:337-244-6852
Mailing Address - Fax:
Practice Address - Street 1:832 JACKSON GIMNICK LOOP
Practice Address - Street 2:
Practice Address - City:RAGLEY
Practice Address - State:LA
Practice Address - Zip Code:70657-6506
Practice Address - Country:US
Practice Address - Phone:337-244-6852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA868014133N00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAP00857372Medicare PIN
LA3B6957460Medicare PIN