Provider Demographics
NPI:1750179628
Name:DEPUTY, KALEY N (RD, LD, MS)
Entity type:Individual
Prefix:
First Name:KALEY
Middle Name:N
Last Name:DEPUTY
Suffix:
Gender:
Credentials:RD, LD, MS
Other - Prefix:
Other - First Name:KALEY
Other - Middle Name:N
Other - Last Name:DICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3901 PARKWAY CIR
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-6362
Mailing Address - Country:US
Mailing Address - Phone:479-587-1700
Mailing Address - Fax:479-587-1366
Practice Address - Street 1:3901 PARKWAY CIR
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-6362
Practice Address - Country:US
Practice Address - Phone:479-587-1700
Practice Address - Fax:479-587-1366
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2040133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered