Provider Demographics
NPI:1982281119
Name:MILLER, KATY MARIE (MA, RD/LD)
Entity type:Individual
Prefix:
First Name:KATY
Middle Name:MARIE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA, RD/LD
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:MARIE
Other - Last Name:LITTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 CHILDRENS AVE RM BNP 501
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-4637
Mailing Address - Country:US
Mailing Address - Phone:405-271-8001
Mailing Address - Fax:
Practice Address - Street 1:1200 CHILDRENS AVE RM BNP 501
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-4637
Practice Address - Country:US
Practice Address - Phone:405-271-8001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKL2555133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric