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General NPI Number Information
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NPI Number | 1013151174
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Entity Type | Organization
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Legal Business Name | KIMBERLY DAVIS, RD/LD, P.C., INC.
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Dates
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Enumeration Date | 04/20/2009
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Last Update Date | 04/20/2009
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Provider Practice Location Address
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Address Line | 1414 N PORTER AVE
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City | NORMAN
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State | OK
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Zip | 73071-6662
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Country | US
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Telephone | 405-326-5403
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Fax | 405-217-3985
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Provider Business Mailing Address
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Address Line | 1414 N PORTER AVE
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City | NORMAN
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State | OK
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Zip | 73071-6662
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Country | US
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Telephone | 405-326-5403
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Fax | 405-217-3985
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Authorized Official
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Title or Position | OWNER
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Name | MS. KIMBERLY DAWN DAVIS-CONIGLIO
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Credential | M.S., RD/LD
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Telephone | 405-326-5403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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