Provider Demographics
NPI:1760813927
Name:MURDOCK, KATHY (RD LD)
Entity Type:Individual
Prefix:MS
First Name:KATHY
Middle Name:
Last Name:MURDOCK
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:PO BOX 1032
Mailing Address - Street 2:8506 HWY. 115
Mailing Address - City:POCAHONTAS
Mailing Address - State:AR
Mailing Address - Zip Code:72455-1032
Mailing Address - Country:US
Mailing Address - Phone:870-378-3550
Mailing Address - Fax:
Practice Address - Street 1:6263 HIGHWAY 49 S
Practice Address - Street 2:AR KIDS PDC
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-6093
Practice Address - Country:US
Practice Address - Phone:870-240-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1314133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered