Healthcare Provider Details

I. General information

NPI: 1255297958
Provider Name (Legal Business Name): ANNA LU NUTRITION PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2025
Last Update Date: 12/27/2025
Certification Date: 12/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3291 S THOMPSON ST STE A101
SPRINGDALE AR
72764-7344
US

IV. Provider business mailing address

1 DOLPHIN LN
BELLA VISTA AR
72715-6541
US

V. Phone/Fax

Practice location:
  • Phone: 479-388-1736
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANNA MARROQUIN
Title or Position: PRESIDENT
Credential: RDN, LD
Phone: 479-388-1736