Individual
STACEY MCCARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 GRANT AVE, JONESBORO, AR 72401-6155
(870) 974-9114
(870) 974-9184
Mailing address
1801 GRANT AVE, JONESBORO, AR 72401-6155
(870) 974-9114
(870) 974-9184
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1299
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1299
DIETIAN
AR
Enumeration date
06/11/2013
Last updated
06/11/2013
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