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General NPI Number Information
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NPI Number | 1720365752
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Entity Type | Organization
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Legal Business Name | ARKANSAS CHILDREN'S HOSPITAL
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Dates
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Enumeration Date | 11/04/2011
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Last Update Date | 11/04/2011
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Provider Practice Location Address
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Address Line | 1 CHILDRENS WAY
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City | LITTLE ROCK
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State | AR
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Zip | 72202-3500
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Country | US
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Telephone | 501-364-2601
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Fax | 501-364-6918
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Provider Business Mailing Address
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Address Line | 1 CHILDRENS WAY
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City | LITTLE ROCK
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State | AR
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Zip | 72202-3500
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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 | CLINICAL DIETITIAN II
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Name | MRS. MEGAN DUNN-MCDERMOTT GREEN
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Credential | MS, RD, CSP, LD
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Telephone | 501-364-2601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number | 1022
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License Number State | AR
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