Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Wayne Anthony Stackhouse

Individual provider Nutritionist · NPI 1073404380

Wayne Anthony Stackhouse is a Nutritionist in Philadelphia, Pennsylvania. Practices as a sole proprietor. Licensed in Pennsylvania.

Licensed in
PA
In the registry since
2025
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Practice location Address checks out

3213 N 27th St
Philadelphia, PA 19129-1808
Phone: (267) 742-4163
Fax: (267) 742-4163
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nutritionist (primary) Taxonomy 133N00000X (PA)

Record details

NPI number1073404380
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 14, 2025
Last updated in NPPESJuly 14, 2025
Certification dateJuly 14, 2025

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