Provider Demographics
NPI:1235467614
Name:COLLINS, KATHERINE E (RD/LD)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:E
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RD/LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 NW 56TH TER
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-7708
Mailing Address - Country:US
Mailing Address - Phone:405-818-4741
Mailing Address - Fax:
Practice Address - Street 1:2216 NW 56TH TER
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-7708
Practice Address - Country:US
Practice Address - Phone:405-818-4741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-24
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1680133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered