Susan Mae Jennings, RD LD
Individual provider Active NPI Registered Dietitian · El Dorado, AR
NPI 1073671855 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1073671855
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 888 (AR)
- Practice address
- 700 West Grove
El Dorado, AR 71730 - Phone
- (879) 864-3474
- NPI assigned
- Dec 5, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 888 | AR | Yes |
Addresses
Primary practice location
700 West Grove
El Dorado, AR 71730
Mailing address
2821 Chaffin Lane
Magnolia, AR 71753
Phone (870) 299-1354
Other providers in El Dorado, AR
- Lanora Jamerson
- James Johnson Enterprises, Inc.
- C'Asia Rynez James
- Jocelyn Jamison
- Jason Jennings
- Eric Lamorris Jermany
- Jerry H Grant, M.D., P.a.
- Randall W Jerry
- Jo O'Guinn-Charles, PLLC
- Casey Johnson
All providers in El Dorado, AR · Registered Dietitian in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.