Individual
STEPHANIE BEARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2825 PARKLAWN DR, MIDWEST CITY, OK 73110-4201
(405) 610-8209
Mailing address
8212 NW 159TH ST, EDMOND, OK 73013-5804
(215) 264-5216
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1884
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1059865
NATIONAL REGISTRATION NUMBER
—
01
—
1884
OKLAHOMA STATE BOARD OF MEDICAL LICENSURE AND SUPERVISION
OK
Enumeration date
11/03/2022
Last updated
11/03/2022
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