Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
STACEY LYNN FOGARTY-BROWN, RD, CSP
Active Sole ProprietorPediatric Nutrition · YPSILANTI, MI
Registration Details
- NPI Number
- 1710638051
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 18, 2022 (4.2574518690611 yrs)
- Last Updated
- Jan 18, 2022
- License
-
86057543
- Sole Proprietor
- Yes
Practice Information
- Address
-
8214 VALLEYVIEW DRYPSILANTI, MI, 481978362Browse MI providers · Browse ZIP 48197
- Phone
- 9893301789
- Primary Specialty
-
Pediatric Nutrition
133VN1004X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.