Provider Demographics
NPI:1649625914
Name:DANS-DIABETES AND NUTRITION SERVICES, LLC
Entity type:Organization
Organization Name:DANS-DIABETES AND NUTRITION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, OWNER AND CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:I
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN, LDN, CDCES
Authorized Official - Phone:501-703-0882
Mailing Address - Street 1:204 SEZANNE DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-5094
Mailing Address - Country:US
Mailing Address - Phone:501-830-3115
Mailing Address - Fax:
Practice Address - Street 1:204 SEZANNE DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-5094
Practice Address - Country:US
Practice Address - Phone:501-830-3115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD02066133V00000X
133VN1005X, 133VN1006X, 133VN1201X, 133VN1501X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, RenalGroup - Single Specialty
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Single Specialty
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Single Specialty
No133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports DieteticsGroup - Single Specialty