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NPI Code Detail

MEDICARE: CLAIRE ELIZABETH GISH

MEDICARE:   CLAIRE ELIZABETH GISH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian634OK

General Provider Information

NPI Number : 1396004388
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLAIRE ELIZABETH GISH
Provider Business Mailing Address
First Line : 1824 S CINCINNATI AVE
Second Line :
City : TULSA
State : OK
Zip : 74119-5226
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1824 S CINCINNATI AVE
Second Line :
City : TULSA
State : OK
Zip : 74119-5226
Country : US
Telephone Number : 214-649-5279
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2012
Last Update Date : 07/22/2020

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Directions to “ CLAIRE ELIZABETH GISH ” Practice Location

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