Individual
ANNICIA PATRICE PETTUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
3011 SUE ST, BENTON, AR 72015-2747
(501) 454-2125
Mailing address
3011 SUE ST, BENTON, AR 72015-2747
(501) 454-2125
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2777
AR
Other
Enumeration date
04/26/2025
Last updated
04/26/2025
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