Provider Demographics
NPI:1043953011
Name:PIERCE, JORDAN LYNN (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:LYNN
Last Name:PIERCE
Suffix:
Gender:
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:LYNN
Other - Last Name:CHAPPELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LD
Mailing Address - Street 1:909 26TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6366
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:909 26TH AVE NW
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6366
Practice Address - Country:US
Practice Address - Phone:405-857-7224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-18
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2633133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered