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NPI Code Detail

MEDICARE: MRS. JENNIFER HERRIN POSTLETHWAITE R.D/L.D

MEDICARE: MRS. JENNIFER HERRIN POSTLETHWAITE R.D/L.D
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 Dietitian1011393OK

General Provider Information

NPI Number : 1447430764
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER HERRIN POSTLETHWAITE R.D/L.D
Provider Business Mailing Address
First Line : 420 NW 6TH ST
Second Line : P.O. BOX 2098
City : OKLAHOMA CITY
State : OK
Zip : 73102-2805
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 500 SW 44TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73109-3540
Country : US
Telephone Number : 405-235-6466
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2007
Last Update Date : 02/03/2010

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