Provider Demographics
NPI:1053669622
Name:STEVENS, JAIME L (RD LMNT)
Entity type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:L
Last Name:STEVENS
Suffix:
Gender:F
Credentials:RD LMNT
Other - Prefix:MRS
Other - First Name:JAIME
Other - Middle Name:L
Other - Last Name:ANDERSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDLMNT
Mailing Address - Street 1:989450 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-9450
Mailing Address - Country:US
Mailing Address - Phone:402-559-3122
Mailing Address - Fax:
Practice Address - Street 1:989450 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-9450
Practice Address - Country:US
Practice Address - Phone:402-559-3122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE888309133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered