Provider Demographics
NPI:1043615941
Name:NUTRITION SOLUTIONS SIMPLIFIED PLLC
Entity Type:Organization
Organization Name:NUTRITION SOLUTIONS SIMPLIFIED PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DIETITIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:HUBBARD
Authorized Official - Suffix:
Authorized Official - Credentials:RD/LD
Authorized Official - Phone:405-818-6801
Mailing Address - Street 1:4500 N CLASSEN BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-4834
Mailing Address - Country:US
Mailing Address - Phone:405-818-6801
Mailing Address - Fax:405-524-5044
Practice Address - Street 1:4500 N CLASSEN BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-4834
Practice Address - Country:US
Practice Address - Phone:405-818-6801
Practice Address - Fax:405-524-5044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLD520133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty