Provider Demographics
NPI:1053664714
Name:RUNDELL, BRITTANY C (RD/LD)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:C
Last Name:RUNDELL
Suffix:
Gender:F
Credentials:RD/LD
Other - Prefix:MRS
Other - First Name:BRITTANY
Other - Middle Name:C
Other - Last Name:HUNTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD/LD
Mailing Address - Street 1:720 N SONGBIRD WAY
Mailing Address - Street 2:
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-2086
Mailing Address - Country:US
Mailing Address - Phone:405-550-2899
Mailing Address - Fax:
Practice Address - Street 1:10400 VINEYARD BLVD STE A
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-3830
Practice Address - Country:US
Practice Address - Phone:405-550-2899
Practice Address - Fax:405-242-5345
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282N00000X
OK1787133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No282N00000XHospitalsGeneral Acute Care Hospital