Provider Demographics
NPI:1043249659
Name:STEVENSON - WATSON, MARGARET KATHERINE (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:KATHERINE
Last Name:STEVENSON - WATSON
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:MRS
Other - First Name:MARGARET
Other - Middle Name:KATHERINE
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:111 CHALLAIN DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-5517
Mailing Address - Country:US
Mailing Address - Phone:501-868-7796
Mailing Address - Fax:
Practice Address - Street 1:1800 BYPASS RD
Practice Address - Street 2:
Practice Address - City:HEBER SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72543-3442
Practice Address - Country:US
Practice Address - Phone:501-887-3257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR502133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5X040OtherMNT PROVIDER