Individual
DR. KINDANN MCMAHAN STONE FAWCETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., RD, LD
Contact information
Practice address
305 E MAIN ST, CABOT, AR 72023-3034
(501) 605-0310
(501) 605-0325
Mailing address
305 E MAIN ST, CABOT, AR 72023-3034
(501) 605-0310
(501) 605-0325
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
011976-01
NY
133V00000X
Registered Dietitian
Primary
2244
AR
133V00000X
Registered Dietitian
2919
OK
133V00000X
Registered Dietitian
DT87888
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6K3543
—
AR
Enumeration date
05/23/2022
Last updated
04/10/2024
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