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NPI Code Detail

MEDICARE: MRS. MEGAN CHRISTINE MAGNESS RD

MEDICARE:  MRS. MEGAN CHRISTINE MAGNESS  RD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian3037AR
2133V00000XRegistered Dietitian1097189

General Provider Information

NPI Number : 1184092504
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MEGAN CHRISTINE MAGNESS RD
Provider Business Mailing Address
First Line : 4301 W MARKHAM ST # 783
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-7101
Country : US
Telephone Number : 501-686-8000
Fax Number : 501-526-5148
Provider Business Practice Location Address
First Line : 4301 W MARKHAM ST # 541
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-7101
Country : US
Telephone Number : 501-526-6477
Fax Number : 501-526-7977
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2015
Last Update Date : 02/23/2026

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Directions to “ MRS. MEGAN CHRISTINE MAGNESS RD” Practice Location

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