Individual
ALEXIS NICOLE CHANCELLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD/LD
Contact information
Practice address
859 E MELTON DR, JAY, OK 74346-2704
(918) 253-1744
Mailing address
PO BOX 350, JAY, OK 74346-0350
(918) 253-1744
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2490
OK
Other
Enumeration date
02/13/2020
Last updated
09/19/2023
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