Individual
MRS. DIANE MARIE MINNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD/LD
Contact information
Practice address
1000 KINGFISHER REGIONAL HOSPITAL DR, KINGFISHER, OK 73750
(405) 375-7962
(405) 375-7998
Mailing address
835 CLARK DR, KINGFISHER, OK 73750-3815
(405) 375-7962
(405) 375-7998
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
998
OK
Other
Enumeration date
11/04/2009
Last updated
11/04/2009
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