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General NPI Number Information
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NPI Number | 1881476356
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Entity Type | Individual
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Provider Name | JENNIFER RODRIGUEZ MS, RD/LD
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Gender | Female
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Dates
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Enumeration Date | 10/18/2023
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Last Update Date | 10/18/2023
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Provider Practice Location Address
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Address Line | 3555 NW 58TH ST STE 910-W
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-4707
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Country | US
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Telephone | 405-885-0270
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Fax |
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Provider Business Mailing Address
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Address Line | 12911 E 32ND ST
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City | TULSA
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State | OK
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Zip | 74134-3209
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Country | US
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Telephone | 918-407-2023
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 2843
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License Number State | OK
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