Individual
NITI PURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
7 SHACKLEFORD WEST BLVD, LITTLE ROCK, AR 72211-3886
(501) 664-5860
(501) 664-0889
Mailing address
7 SHACKLEFORD WEST BLVD, LITTLE ROCK, AR 72211-3886
(501) 664-5860
(501) 664-0889
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1689
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689
DIETETIC LICENSING BOARD
AR
Enumeration date
11/06/2017
Last updated
11/06/2017
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