Carla Jean Stevens, RD, CD | |
5000 Memorial Dr, Two Rivers, WI 54241-3900 | |
(920) 794-5114 | |
(920) 794-5492 |
Full Name | Carla Jean Stevens |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 5000 Memorial Dr, Two Rivers, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1821466673 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | 930302 (Wisconsin) | Primary |
Provider Name | Aurora Medical Group, Inc. |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
Mailing Address | Practice Location Address |
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Carla Jean Stevens, RD, CD 5000 Memorial Dr, Two Rivers, WI 54241-3900 Ph: (920) 794-5114 | Carla Jean Stevens, RD, CD 5000 Memorial Dr, Two Rivers, WI 54241-3900 Ph: (920) 794-5114 |
Maureen A Mahlik Puls, RD Dietitian Medicare: Accepting Medicare Assignments Practice Location: 5000 Memorial Dr, Two Rivers, WI 54241 Phone: 920-794-5231 | |
Mrs. Kelly A. Litersky, MS, RD, CD Dietitian Medicare: Accepting Medicare Assignments Practice Location: 5000 Memorial Dr, Two Rivers, WI 54241 Phone: 920-794-5114 Fax: 920-794-5492 | |
Virginia Matthews, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 5000 Memorial Dr, Two Rivers, WI 54241 Phone: 920-794-5114 |