Healthcare Provider Details

I. General information

NPI: 1104704006
Provider Name (Legal Business Name): SARAI RAMIREZ RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 MUSEUM RD STE 104
CONWAY AR
72032-4761
US

IV. Provider business mailing address

8125 HOMESTEAD DR
MABELVALE AR
72103-4233
US

V. Phone/Fax

Practice location:
  • Phone: 501-932-9010
  • Fax:
Mailing address:
  • Phone: 870-279-7276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2851
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: