Provider Demographics
NPI:1689416950
Name:MENESES-FURUSETH, ISABELLA (MSCN)
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:
Last Name:MENESES-FURUSETH
Suffix:
Gender:F
Credentials:MSCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 LITTLE FLOCK DR
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-7031
Mailing Address - Country:US
Mailing Address - Phone:479-925-5933
Mailing Address - Fax:
Practice Address - Street 1:1601 LITTLE FLOCK DR
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-7031
Practice Address - Country:US
Practice Address - Phone:479-925-5933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-08
Last Update Date:2024-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist