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Individual

DIANE MCKINNEY JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.R.D.L.D.

Contact information

Practice address
118 E SUNBRIDGE DR, FAYETTEVILLE, AR 72703-2830
(479) 444-1400
(479) 444-1422
Mailing address
118 E SUNBRIDGE DR, FAYETTEVILLE, AR 72703-2830
(479) 444-1400

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
0139
AR

Other

Enumeration date
07/25/2008
Last updated
07/25/2008
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