NPI 1093087355

Jennifer Southard, MSRDLD

Practitioner Registered Dietitian Edmond, OK

Practice location

Address: 3120 S Boulevard STE 127, Edmond, OK 73013-5308
Phone: (405) 960-3120
Mailing address: 3126 S Boulevard STE 127, Edmond, OK 73013-5308

Registered specialties

Registered Dietitian Primary

Dietary & Nutritional Service Providers Taxonomy 133V00000X Licence 1720 (OK)

Other Dietitian, Registered providers in Oklahoma →

Registry record

NPI: 1093087355
Entity type: Individual
Sex (as registered): Female
NPI issued: 2 Feb 2012
Record last updated: 3 Mar 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.