Provider Demographics
NPI:1568791556
Name:CSICSILA, ERIN LEE (RD LD)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:LEE
Last Name:CSICSILA
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 SPRINGHILL DR
Mailing Address - Street 2:BAPTIST HEALTH MEDIACL CENTER
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2922
Mailing Address - Country:US
Mailing Address - Phone:501-202-3704
Mailing Address - Fax:
Practice Address - Street 1:3333 SPRINGHILL DR
Practice Address - Street 2:BAPTIST HEALTH MEDIACL CENTER
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2922
Practice Address - Country:US
Practice Address - Phone:501-202-3704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1146133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered