Provider Demographics
NPI:1104325844
Name:LOYD, LEAH RACHEL (RDN/LD)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:RACHEL
Last Name:LOYD
Suffix:
Gender:F
Credentials:RDN/LD
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:RACHEL
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD LD
Mailing Address - Street 1:11560 N 135TH EAST AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-5755
Mailing Address - Country:US
Mailing Address - Phone:918-553-1188
Mailing Address - Fax:855-873-6538
Practice Address - Street 1:601 SW JENNINGS AVE
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74003-4429
Practice Address - Country:US
Practice Address - Phone:918-553-1188
Practice Address - Fax:855-873-6538
Is Sole Proprietor?:No
Enumeration Date:2018-02-08
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2330133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered