Individual
JENNIFER LELA GILLISPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD, CNSC
Contact information
Practice address
700 NE 13TH ST, OKLAHOMA CITY, OK 73104-5004
(405) 271-8001
Mailing address
2716 NW 67TH ST, OKLAHOMA CITY, OK 73116-4614
(405) 271-8001
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2442
OK
Other
Enumeration date
05/30/2023
Last updated
05/30/2023
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