Provider Demographics
NPI:1902116817
Name:BELL, KATHRYN ELIZABETH (MS RD LD)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:ELIZABETH
Last Name:BELL
Suffix:
Gender:F
Credentials:MS RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 BRADEN ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72076-3721
Mailing Address - Country:US
Mailing Address - Phone:501-453-5629
Mailing Address - Fax:501-453-6907
Practice Address - Street 1:1400 BRADEN ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72076-3721
Practice Address - Country:US
Practice Address - Phone:501-339-8310
Practice Address - Fax:501-453-6907
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-13
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2251133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered