Individual
STEPHANIE FERNANDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
1000 BALLPARK WAY STE 400, ARLINGTON, TX 76011-5170
(864) 710-0140
Mailing address
3205 CUMBERLAND BLVD SE UNIT 630, ATLANTA, GA 30339-4431
(864) 710-0140
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86091322
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86091322
ACADEMY OF NUTRITION AND DIETETICS
—
01
—
DT85680
TEXAS DEPARTMENT OF LICENSING AND REGULATION
TX
Enumeration date
03/13/2017
Last updated
12/02/2019
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