| Doctor Name: | STEPHANIE L MOORE |
| NPI Number: | 1760651947 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DIETITIAN |
| License Number: | D1108 |
| Business Practice Address: | 66 Old Airport Rd Hattiesburg, MS - 394018382 |
| Business Phone Number: | 6015822619 |
| Business Fax Number: | 6015444557 |
| Mailing Address: | Po Box 1729, HATTIESBURG |
| State: | MS |
| Postal Code: | 394031729 |
| Phone Number: | 6015458700 |
| Fax Number: | 6015825461 |
| NPI Enumeration Date: | 02/21/2008 |
| NPI Last Update Date: | 02/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | D1108 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |