Provider Demographics
NPI:1740655463
Name:SHARP, BRITTNEY (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:SHARP
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 1:688 E MILLSAP RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4095
Mailing Address - Country:US
Mailing Address - Phone:479-463-3072
Mailing Address - Fax:479-463-3077
Practice Address - Street 1:688 E MILLSAP RD
Practice Address - Street 2:SUITE 100
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4095
Practice Address - Country:US
Practice Address - Phone:479-463-3072
Practice Address - Fax:479-463-3077
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-07
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1468133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered