Provider Demographics
NPI:1043468549
Name:HARDIN, ANNA PENNINGTON (MS, RD, LD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:PENNINGTON
Last Name:HARDIN
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7621 HIGHWAY 46 N
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:AR
Mailing Address - Zip Code:72150-6161
Mailing Address - Country:US
Mailing Address - Phone:501-773-1617
Mailing Address - Fax:
Practice Address - Street 1:7621 HIGHWAY 46 NORTH
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:AR
Practice Address - Zip Code:72150-6161
Practice Address - Country:US
Practice Address - Phone:501-773-1617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR972133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered