Ellen Suratt Stanback, RD,LD,CLC

Registered Dietitian · Lithonia, GA

Individual Active NPI

NPI number 1780768663

Practice location

2277 Stone Mountain Lithonia Rd
Lithonia, GA 30058-5252
Phone
(770) 484-2600
Fax
(770) 484-3830

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NPI record

NPI
1780768663
Entity type
Individual (Type 1)
Enumeration date
October 25, 2006
Last updated
July 8, 2007
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Registered Dietitian Primary 133V00000X LD001907 GA

Mailing address

3177 Kensington Rd
Avondale Estates, GA 30002-1457
Phone
(404) 299-1150

About Ellen Stanback

Ellen Suratt Stanback, RD,LD,CLC is a healthcare provider registered in the NPI registry with the primary taxonomy Registered Dietitian (code 133V00000X). The practice location is 2277 Stone Mountain Lithonia Rd, Lithonia, GA 30058-5252. The NPI number 1780768663 was assigned on October 25, 2006 and the record was last updated on July 8, 2007.

Ellen Stanback lists a license in the registry: #LD001907 (GA) for Registered Dietitian. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Ellen Suratt Stanback, RD,LD,CLC?

The NPI number is 1780768663.

What is the phone number of Ellen Stanback?

The phone number listed for the practice location is (770) 484-2600.

Where is Ellen Stanback located?

2277 Stone Mountain Lithonia Rd, Lithonia, GA 30058-5252.

What is the taxonomy code for Ellen Stanback?

The primary taxonomy code is 133V00000X – Registered Dietitian.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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