Individual
STEPHANIE CHEKOS BAXLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
955 RIBAUT RD, BEAUFORT, SC 29902
(843) 522-5200
Mailing address
955 RIBAUT ROAD, BMAC CREDENTIALING COORDINATOR, BEAUFORT, SC 29902-5441
(843) 522-5674
(843) 522-5678
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1605
SC
133V00000X
Registered Dietitian
LD004069
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DT1146
—
SC
Enumeration date
09/09/2013
Last updated
07/23/2019
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