Provider Demographics
NPI:1073001061
Name:CURLEY, MARCIA (RDN)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:CURLEY
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 W BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-8614
Mailing Address - Country:US
Mailing Address - Phone:918-638-8949
Mailing Address - Fax:
Practice Address - Street 1:4301 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-8614
Practice Address - Country:US
Practice Address - Phone:918-638-8949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK759133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered