Individual
JORDAN TACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
14004 HILARO SPRINGS RD, LITTLE ROCK, AR 72206
(501) 860-1015
Mailing address
14004 HILARO SPRINGS RD, LITTLE ROCK, AR 72206
(501) 860-1015
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1875
AR
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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