Provider Demographics
NPI:1558610659
Name:MASSEY, KAREN KAY (RD, LD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:KAY
Last Name:MASSEY
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 1:3300 NW EXPRESSWAY
Mailing Address - Street 2:INTEGRIS-BAPTIST MEDICAL CENTER
Mailing Address - City:OKC
Mailing Address - State:OK
Mailing Address - Zip Code:73112
Mailing Address - Country:US
Mailing Address - Phone:405-949-3544
Mailing Address - Fax:405-951-9954
Practice Address - Street 1:3300 NW EXPRESSWAY
Practice Address - Street 2:INTEGRIS-BAPTIST MEDICAL CENTER
Practice Address - City:OKC
Practice Address - State:OK
Practice Address - Zip Code:73112-4481
Practice Address - Country:US
Practice Address - Phone:405-949-3544
Practice Address - Fax:405-951-9954
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK293133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered