Provider Demographics
NPI:1679500755
Name:ZELLMER, RUTH ANN (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:ANN
Last Name:ZELLMER
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 1:14 DANIEL DR
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-4841
Mailing Address - Country:US
Mailing Address - Phone:501-831-1162
Mailing Address - Fax:
Practice Address - Street 1:BAPTIST HEALTH MEDICAL CENTER-NORTH LITTLE ROCK
Practice Address - Street 2:3333 SPRINGHILL DR.
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114
Practice Address - Country:US
Practice Address - Phone:501-202-3089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR268133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5X041OtherMNT PROVIDER