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Organization

NOURISH NUTRITION & DIABETES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISA JOHNSTON RD (OWNER AND DIETITIAN)
(405) 509-1294
Entity
Organization

Contact information

Practice address
1601 S STATE ST STE 500, EDMOND, OK 73013-3698
(405) 254-6453
(405) 562-8735
Mailing address
1601 S STATE ST STE 500, EDMOND, OK 73013-3698
(405) 254-6453
(405) 562-8735

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1559
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NONE
Enumeration date
01/29/2014
Last updated
10/07/2025
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