Individual
MRS. MIRANDA LEE CORNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
620 N MAIN ST, HARRISON, AR 72601-2911
(870) 414-4000
Mailing address
114 W SOUTH ST, NIXA, MO 65714-8861
(816) 738-4808
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86108566
AR
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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