MEDICARE: NUTRITION PARTNERS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043246242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUTRITION PARTNERS LLC

Provider Business Mailing Address
First Line	:	9636 N MAY AVE
Second Line	:	SUITE 274
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-2727
Country	:	US
Telephone Number	:	405-848-9344
Fax Number	:	405-302-0333

Provider Business Practice Location Address
First Line	:	9636 N MAY AVE
Second Line	:	SUITE 274
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-2727
Country	:	US
Telephone Number	:	405-848-9344
Fax Number	:	405-302-0333

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DIANE SHEETS COOKE
Credential	:	RD/LD
Telephone Number	:	405-848-9344

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	11/11/2009

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Directions to “NUTRITION PARTNERS LLC ” Practice Location

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