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General NPI Number Information
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NPI Number | 1073082053
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Entity Type | Individual
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Provider Name | NATALIE BULES RD, LD
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Gender | Female
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Dates
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Enumeration Date | 11/19/2018
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Last Update Date | 11/19/2018
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Provider Practice Location Address
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Address Line | 688 E MILLSAP RD STE 100
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-3930
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Country | US
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Telephone | 479-463-3070
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Fax |
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Provider Business Mailing Address
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Address Line | 2350 S ED EDWARDS RD
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-0761
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 1464
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License Number State | AR
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