Provider Demographics
NPI:1720055692
Name:ELIOT, KATHRIN ANDREWS (RD)
Entity type:Individual
Prefix:
First Name:KATHRIN
Middle Name:ANDREWS
Last Name:ELIOT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73019-3142
Mailing Address - Country:US
Mailing Address - Phone:405-325-4611
Mailing Address - Fax:405-325-7065
Practice Address - Street 1:620 ELM AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73019-3142
Practice Address - Country:US
Practice Address - Phone:405-325-4611
Practice Address - Fax:405-325-7065
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1268133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered