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General NPI Number Information
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NPI Number | 1669313938
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Entity Type | Individual
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Provider Name | CARA LYNN HALVERSTADT RDN
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Gender | Female
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Dates
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Enumeration Date | 04/02/2026
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 224 PHEASANT CIR
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City | ALTUS
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State | OK
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Zip | 73521-9785
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Country | US
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Telephone | 512-693-7045
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Fax |
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Provider Business Mailing Address
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Address Line | 224 PHEASANT CIR
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City | ALTUS
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State | OK
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Zip | 73521-9785
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Country | US
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Telephone | 801-995-8257
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Fax |
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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 | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number | 3036
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License Number State | OK
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