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General NPI Number Information
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NPI Number | 1982856647
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Entity Type | Individual
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Provider Name | JANA DEAN SHOEMAKER MS, RD, LD
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Gender | Female
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Dates
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Enumeration Date | 10/14/2008
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Last Update Date | 08/06/2009
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Provider Practice Location Address
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Address Line | 609 W MAPLE AVE
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City | SPRINGDALE
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State | AR
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Zip | 72764-5335
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Country | US
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Telephone | 479-757-4366
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Fax |
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Provider Business Mailing Address
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Address Line | 191 MADISON 2110
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City | HUNTSVILLE
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State | AR
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Zip | 72740-7928
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Country | US
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Telephone | 479-422-8818
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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 | 1014
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License Number State | AR
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