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General NPI Number Information
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NPI Number | 1609090372
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Entity Type | Individual
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Provider Name | SUSAN KAY PACIFIC RD,LD
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Gender | Female
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 3400 W TECUMSEH RD STE 206
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City | NORMAN
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State | OK
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Zip | 73072-1810
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Country | US
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Telephone | 405-307-5731
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Fax | 405-307-3719
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Provider Business Mailing Address
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Address Line | PO BOX 1330
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City | NORMAN
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State | OK
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Zip | 73070-1330
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Country | US
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Telephone | 405-307-6630
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Fax | 405-307-6660
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 958
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License Number State | OK
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