Provider Demographics
NPI:1932527025
Name:SHUEY, STEPHANIE (MPS, RDN, LDN, IBCLC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:SHUEY
Suffix:
Gender:F
Credentials:MPS, RDN, LDN, IBCLC
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:WEAVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPS, RDN, LDN, IBCLC
Mailing Address - Street 1:2777 ZION RD
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-7649
Mailing Address - Country:US
Mailing Address - Phone:814-883-6090
Mailing Address - Fax:
Practice Address - Street 1:2777 ZION RD
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-7649
Practice Address - Country:US
Practice Address - Phone:814-883-6090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-04
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAL-36230174N00000X
PADN008746133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174N00000XOther Service ProvidersLactation Consultant, Non-RN