Provider Demographics
NPI:1568351948
Name:TAYLOR, LAUREN RENEE' (RD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:RENEE'
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:RENEE'
Other - Last Name:KUYKENDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9905 S PENNSYLVANIA AVE STE A
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-6920
Mailing Address - Country:US
Mailing Address - Phone:918-732-9090
Mailing Address - Fax:
Practice Address - Street 1:221 S FLORENCE AVE STE 105
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-7264
Practice Address - Country:US
Practice Address - Phone:918-732-9090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-01
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3142133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered