Provider Demographics
NPI:1215776182
Name:WASHBURN, WHITNEY RENEE (RD LD)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:RENEE
Last Name:WASHBURN
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 PROVIDENCE DR
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-3023
Mailing Address - Country:US
Mailing Address - Phone:254-315-4218
Mailing Address - Fax:
Practice Address - Street 1:2901 PROVIDENCE DR
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-3023
Practice Address - Country:US
Practice Address - Phone:254-315-4218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered