Individual
MRS. STACY LYNN COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., R.D./L.D., CDE
Contact information
Practice address
1010 24TH AVE NW STE 100, NORMAN, OK 73069-6488
(405) 801-4050
Mailing address
1804 QUAIL RUN, NEWCASTLE, OK 73065-5831
(405) 226-0960
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1479
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OKAAA1577
MEDICARE PTAN
OK
Enumeration date
02/24/2011
Last updated
07/21/2022
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