Individual
KATHYRN BANDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS RD LD
Contact information
Practice address
10109 E 79TH ST, TULSA, OK 74133-4564
(918) 636-7141
Mailing address
10109 E 79TH ST, TULSA, OK 74133-4564
Taxonomy
Speciality
Code
Description
License number
State
133VN1301X
Oncology Nutrition Registered Dietitian
Primary
927863
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
927863
RD/LD
OK
Enumeration date
04/15/2020
Last updated
04/21/2020
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