Provider Demographics
NPI:1932914439
Name:WILKERSON, LEXI (RD, LD, RDN)
Entity type:Individual
Prefix:
First Name:LEXI
Middle Name:
Last Name:WILKERSON
Suffix:
Gender:F
Credentials:RD, LD, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 PENDLETON DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-2939
Mailing Address - Country:US
Mailing Address - Phone:903-475-2593
Mailing Address - Fax:
Practice Address - Street 1:1904 PENDLETON DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-2939
Practice Address - Country:US
Practice Address - Phone:903-475-2593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2907133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered