Individual
REGINA A STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
199 ADAMS STREET, LIBERTY, KY 42539
(606) 678-4761
(606) 676-9671
Mailing address
500 BOURNE AVE, SOMERSET, KY 42501-1916
(606) 678-4761
(606) 676-9671
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1726
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20001012
—
KY
05
—
20023016
—
KY
05
—
20027017
—
KY
05
—
20029013
—
KY
05
—
20044012
—
KY
05
—
20074019
—
KY
05
—
20100012
—
KY
05
—
20101014
—
KY
05
—
20109013
—
KY
05
—
20116018
—
KY
05
—
20901211
—
KY
Enumeration date
02/26/2010
Last updated
04/25/2012
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