Individual
LIESL KRAUTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD/LD
Contact information
Practice address
6655 S YALE AVE, TULSA, OK 74136-3326
(918) 491-3702
Mailing address
PO BOX 707001, TULSA, OK 74170-7001
(888) 247-0125
(918) 502-8001
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
800
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200963650A
—
OK
Enumeration date
12/16/2020
Last updated
06/11/2021
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