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General NPI Number Information
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NPI Number | 1750240339
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Entity Type | Individual
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Provider Name | DANIEL RENARD ANDERSON JR. BS
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Gender | Male
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 5305 MCCLANAHAN DR STE E2
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-7076
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Country | US
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Telephone | 903-556-9594
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Fax |
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Provider Business Mailing Address
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Address Line | 6108 MCPHERSON RD
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City | LITTLE ROCK
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State | AR
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Zip | 72204-8827
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Country | US
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Telephone | 903-556-9594
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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