Healthcare Provider Details

I. General information

NPI: 1043246242
Provider Name (Legal Business Name): NUTRITION PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 11/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9636 N MAY AVE SUITE 274
OKLAHOMA CITY OK
73120-2727
US

IV. Provider business mailing address

9636 N MAY AVE SUITE 274
OKLAHOMA CITY OK
73120-2727
US

V. Phone/Fax

Practice location:
  • Phone: 405-848-9344
  • Fax: 405-302-0333
Mailing address:
  • Phone: 405-848-9344
  • Fax: 405-302-0333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: DIANE SHEETS COOKE
Title or Position: PRESIDENT
Credential: RD/LD
Phone: 405-848-9344