Healthcare Provider Details

I. General information

NPI: 1689416950
Provider Name (Legal Business Name): ISABELLA MENESES-FURUSETH MSCN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2024
Last Update Date: 06/30/2024
Certification Date: 06/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 LITTLE FLOCK DR
ROGERS AR
72756-7031
US

IV. Provider business mailing address

1601 LITTLE FLOCK DR
ROGERS AR
72756-7031
US

V. Phone/Fax

Practice location:
  • Phone: 479-925-5933
  • Fax:
Mailing address:
  • Phone: 479-925-5933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: