Healthcare Provider Details

I. General information

NPI: 1538326715
Provider Name (Legal Business Name): NUTRITION SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 10/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 NW 72ND ST STE 232
WARR ACRES OK
73132
US

IV. Provider business mailing address

5601 NW 72ND ST STE 200
WARR ACRES OK
73132-5920
US

V. Phone/Fax

Practice location:
  • Phone: 405-603-1941
  • Fax: 405-603-1942
Mailing address:
  • Phone: 405-603-1941
  • Fax: 405-603-1942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MEGHAN VAN CAMP
Title or Position: RD/OWNER
Credential:
Phone: 405-603-1941