Individual
KATHERINE AINSLEY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNC
Contact information
Practice address
4564 S HARVARD AVE STE B, TULSA, OK 74135-2918
(918) 508-2220
Mailing address
4564 S HARVARD AVE STE B, TULSA, OK 74135-2918
(918) 508-2220
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
1220801859
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T084173163
INSURANCE
—
Enumeration date
05/12/2022
Last updated
05/17/2022
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