Provider Demographics
NPI:1669367868
Name:STEPHENS, WENDY JEANNE (RDN, LD)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:JEANNE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 EL CORTEZ AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-3911
Mailing Address - Country:US
Mailing Address - Phone:702-810-3307
Mailing Address - Fax:
Practice Address - Street 1:500 N RAINBOW BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-1061
Practice Address - Country:US
Practice Address - Phone:702-508-0630
Practice Address - Fax:702-508-0637
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV86153901133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered