Individual
STACIE ANNE HUNTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1935 MEDICAL DISTRICT DR, DALLAS, TX 75235-7701
(217) 456-2178
Mailing address
1011 W TUCKER BLVD, ARLINGTON, TX 76013
(817) 791-6263
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
164005845
IL
133V00000X
Registered Dietitian
Primary
DT83045
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
330110301
—
TX
01
—
8EK221
BLUE CROSS BLUE SHIELD
—
Enumeration date
02/24/2013
Last updated
05/29/2015
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