Brett Herman Baney, R.D.
Individual provider Active NPI Registered Dietitian · Fayetteville, AR
NPI 1992019830 · NPPES record last updated Mar 11, 2022
Key facts
- NPI
- 1992019830
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- DN004251 (PA)
- Practice address
- 1100 N College Ave
Fayetteville, AR 72703-1944 - Phone
- (479) 790-0458
- NPI assigned
- Aug 3, 2010
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN004251 | PA | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DN004251 | PA | Yes |
Addresses
Primary practice location
1100 N College Ave
Fayetteville, AR 72703-1944
Mailing address
1100 N College Ave
Fayetteville, AR 72703-1944
Phone (479) 790-0458
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All providers in Fayetteville, 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 Mar 11, 2022. 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.