Individual
MS. DEBBIE FAYE KEETER - MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS. RD/LD.CDE
Contact information
Practice address
1900 N 14TH ST, PONCA CITY, OK 74601-2035
(580) 765-0269
(580) 718-2904
Mailing address
703 HOLMES AVE, CUSHING, OK 74023-4703
(918) 399-3593
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
676
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100662190C
—
OK
Enumeration date
11/07/2007
Last updated
06/12/2014
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