Healthcare Provider Details

I. General information

NPI: 1922380864
Provider Name (Legal Business Name): DAYA ANN CHERIAN RD/LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2011
Last Update Date: 09/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N STONEWALL AVE AHB 1082
OKLAHOMA CITY OK
73117-1215
US

IV. Provider business mailing address

1200 N STONEWALL AVE AHB 3057
OKLAHOMA CITY OK
73117-1215
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-2866
  • Fax: 405-271-3360
Mailing address:
  • Phone: 405-271-2113
  • Fax: 405-271-1560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1781
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: