Provider Demographics
NPI:1841996600
Name:BAGGETT, RYAN MICHELLE (RD)
Entity type:Individual
Prefix:MRS
First Name:RYAN
Middle Name:MICHELLE
Last Name:BAGGETT
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 1:4000 SHEFFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-7335
Mailing Address - Country:US
Mailing Address - Phone:405-905-9228
Mailing Address - Fax:
Practice Address - Street 1:301 NW 132ND ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-2316
Practice Address - Country:US
Practice Address - Phone:405-905-9228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1902133VN1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics