Individual
MS. KAYLA HICKELHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD/LD
Contact information
Practice address
1001 S 41ST ST E, MUSKOGEE, OK 74403-6253
(918) 781-6437
Mailing address
1001 S 41ST ST E, MUSKOGEE, OK 74403-6253
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2698
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
86289082
—
OK
Enumeration date
02/04/2022
Last updated
02/04/2022
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