Healthcare Provider Details

I. General information

NPI: 1982205795
Provider Name (Legal Business Name): ARKANSAS HEALTH AND NUTRITION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2020
Last Update Date: 11/06/2020
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S SHACKLEFORD RD STE 300
LITTLE ROCK AR
72211-3848
US

IV. Provider business mailing address

900 S SHACKLEFORD RD STE 300
LITTLE ROCK AR
72211-3848
US

V. Phone/Fax

Practice location:
  • Phone: 501-352-1550
  • Fax: 501-500-6370
Mailing address:
  • Phone: 501-352-1550
  • Fax: 501-500-6370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MARY ELIZABETH DAY
Title or Position: OWNER
Credential: MS, RDN. LDN
Phone: 501-352-1550