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General NPI Number Information
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NPI Number | 1396483582
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Entity Type | Individual
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Provider Name | MISTI STRASNER RD
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Gender | Female
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Dates
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Enumeration Date | 05/26/2022
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Last Update Date | 05/26/2022
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Provider Practice Location Address
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Address Line | 131 POLK ROAD 96
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City | MENA
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State | AR
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Zip | 71953-8590
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Country | US
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Telephone | 501-622-0008
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Fax |
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Provider Business Mailing Address
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Address Line | 131 POLK ROAD 96
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City | MENA
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State | AR
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Zip | 71953-8590
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Country | US
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Telephone | 501-622-0008
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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 | 0806
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 133VN1005X
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Taxonomy Name | Renal Nutrition Registered Dietitian
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License Number | 915331
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License Number State |
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 2008
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License Number State | OK
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