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General NPI Number Information
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NPI Number | 1699662817
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Entity Type | Organization
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Legal Business Name | AMY QUALLS REGISTERED DIETITIAN NUTRITIONIST
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Dates
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Enumeration Date | 06/20/2025
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Last Update Date | 06/25/2026
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Provider Practice Location Address
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Address Line | 404 N SPRUCE ST
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City | SEARCY
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State | AR
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Zip | 72143-4231
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Country | US
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Telephone | 501-238-0267
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Fax | 844-990-4180
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Provider Business Mailing Address
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Address Line | 404 N SPRUCE ST
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City | SEARCY
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State | AR
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Zip | 72143-4231
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Country | US
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Telephone | 501-238-0267
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Fax | 844-990-4180
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Authorized Official
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Title or Position | EMPLOYEE
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Name | AMY N QUALLS
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Credential | PHD, RD
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Telephone | 870-834-2611
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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 |
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License Number State |
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