Individual
ELIZABETH BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4444 E 41ST ST, TULSA, OK 74135-2527
(918) 619-4400
(918) 619-4960
Mailing address
PO BOX 268838, OKLAHOMA CITY, OK 73126-8838
(918) 619-4400
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD2033
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200597370A
—
OK
Enumeration date
11/19/2014
Last updated
03/26/2025
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