Provider Demographics
NPI:1396483582
Name:STRASNER, MISTI (RD)
Entity type:Individual
Prefix:MRS
First Name:MISTI
Middle Name:
Last Name:STRASNER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 POLK ROAD 96
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-8590
Mailing Address - Country:US
Mailing Address - Phone:501-622-0008
Mailing Address - Fax:
Practice Address - Street 1:131 POLK ROAD 96
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-8590
Practice Address - Country:US
Practice Address - Phone:501-622-0008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR0806133V00000X
915331133VN1005X
OK2008133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal