Provider Demographics
NPI:1063151215
Name:ROBINSON, STARLA D (MS, RD, CSOWM, LD)
Entity type:Individual
Prefix:
First Name:STARLA
Middle Name:D
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MS, RD, CSOWM, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 REDBUD ST
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-5720
Mailing Address - Country:US
Mailing Address - Phone:918-760-2724
Mailing Address - Fax:
Practice Address - Street 1:345 REDBUD ST
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-5720
Practice Address - Country:US
Practice Address - Phone:918-760-2724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-03
Last Update Date:2024-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND13301133V00000X
GALD007145133V00000X
IA127070133V00000X
KS3109133V00000X
NCL008042133V00000X
SCLRD.2985133V00000X
TXDT89678133V00000X
WADI61587245133V00000X
WI5829-29133V00000X
OK2295133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered