Provider Demographics
NPI:1548447782
Name:STEADY, JANET (MS, RD, LD)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:
Last Name:STEADY
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 VISTA DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-6894
Mailing Address - Country:US
Mailing Address - Phone:207-799-4246
Mailing Address - Fax:
Practice Address - Street 1:11 VISTA DR
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-6894
Practice Address - Country:US
Practice Address - Phone:207-799-4246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDI659133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME061211OtherANTHEM
ME3614847OtherAETNA