Connie Jean Stefanski, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

712110 Issued in MI

Practice address

11800 E 12 Mile Road
St John Macomb Hospital PT Education Dept Mec
Warren, MI 48093-3472

Phone

(586) 573-5697

Fax

(586) 576-4119

NPI assigned

May 30, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212105600000",
    "number": "1962660506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 E 12 MILE ROAD",
            "address_2": "ST JOHN MACOMB HOSPITAL PT EDUCATION DEPT MEC",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933472",
            "telephone_number": "586-573-5697",
            "fax_number": "586-576-4119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 E 12 MILE ROAD",
            "address_2": "ST JOHN MACOMB HOSPITAL PT EDUCATION DEPT MEC",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933472",
            "telephone_number": "586-573-5697",
            "fax_number": "586-576-4119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFANSKI",
        "first_name": "CONNIE",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-30",
        "last_updated": "2008-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "712110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Lee Stav, MD
• Allen N Stawis, MD
• Peter R Stayer, RPH.
• Elisabeth Ann Steczek, D.C.
• Mary E Steele, MD
• Destiny Stegar
• Christine A Stein, PA
• Tasharra Latrice Stephen-Green, NURSE PRACTITIONER
• Blessing Stephen, M.D
• Denise Ashley Stephens

• Registered Dietitian in Warren, MI
• Providers in Warren, MI by specialty
• Registered Dietitian in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.