IndividualActive
Amanda Wilson, RN
NPI 1962246207 · Nutrition Support Registered Nurse · Fayetteville, AR
Provider details
- NPI number
- 1962246207
- Entity type
- Individual
- Primary specialty
- Nutrition Support Registered NurseNursing Service Providers
- Credential
- RN
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Nursing Service Providers
- Nutrition Education Nutritionist133NN1002X
Dietary & Nutritional Service Providers
Practice location
229 N Block Ave
Fayetteville, AR 72701-5204
Phone: (479) 200-2749
Approximate (ZIP-level) locationGet directions
Mailing address
3610 N Tower Cir
Fayetteville, AR 72704-7402
Registry dates
- Enumerated
- 2024-06-21
- Last updated
- 2024-06-21
- Certified
- 2024-06-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.