Provider Demographics
NPI:1417847864
Name:STEVENS, EVA-LYNN (RD/LDN)
Entity type:Individual
Prefix:
First Name:EVA-LYNN
Middle Name:
Last Name:STEVENS
Suffix:
Gender:F
Credentials:RD/LDN
Other - Prefix:
Other - First Name:EVA-LYNN
Other - Middle Name:MARIE
Other - Last Name:CLOUTIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:9866 LIBERTY CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-2604
Mailing Address - Country:US
Mailing Address - Phone:240-409-9293
Mailing Address - Fax:
Practice Address - Street 1:9866 LIBERTY CT
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-2604
Practice Address - Country:US
Practice Address - Phone:240-409-9293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND8203133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered