Individual
MRS. SANDRA H STUART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RDN, CSSD, LD
Contact information
Practice address
301 N 1ST ST, ALTUS AFB, OK 73523-5004
(580) 481-5244
Mailing address
301 N 1ST ST, ALTUS AFB, OK 73523-5004
(580) 481-5244
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
133V00000X
Registered Dietitian
LD004221
GA
133VN1501X
Sports Dietetics Nutrition Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2775
STATE OF OKLAHOMA
OK
01
—
LD004221
STATE OF GEORGIA
GA
Enumeration date
07/15/2016
Last updated
09/27/2023
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