Wallace, Ama Gean
Wallace, Ama Gean is an individual health care provider with primary practice located at 2200 Fort Roots Dr , North Little Rock AR 72114-1709. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Wallace, Ama Gean can be contacted via phone (501) 257-2017.Contact Information
Primary practice address
2200 Fort Roots Dr
North Little Rock AR 72114-1709
Phone: (501) 257-2017
Fax: (501) 257-2026
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dietary & Nutritional Service Providers / Dietitian, Registered | 133V00000X | 0257 | Arkansas |
Profile Details
| NPI number | 1982796405 |
|---|---|
| LBN Legal business name | Wallace, Ama Gean |
| Credentials | Registered Dietitian (RD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 29th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982796405 | NPPES |
| Arkansas | Other | R660145 | REGISTRATION NUMBER |
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