Provider Demographics
NPI:1427701911
Name:NEWTRITION: DIETITIAN CONSULTING, LLC
Entity type:Organization
Organization Name:NEWTRITION: DIETITIAN CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:POTTS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, RD, LD
Authorized Official - Phone:501-492-9609
Mailing Address - Street 1:8 SHACKLEFORD PLZ STE 311
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-1852
Mailing Address - Country:US
Mailing Address - Phone:479-747-1522
Mailing Address - Fax:
Practice Address - Street 1:8 SHACKLEFORD PLZ STE 311
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-1852
Practice Address - Country:US
Practice Address - Phone:479-747-1522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center