Provider Demographics
NPI:1083811947
Name:CUNNINGHAM, BARBARA LEE (RD,LD)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:LEE
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:RD,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9912 INDIGO RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-7428
Mailing Address - Country:US
Mailing Address - Phone:405-691-5302
Mailing Address - Fax:
Practice Address - Street 1:9912 INDIGO RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-7428
Practice Address - Country:US
Practice Address - Phone:405-691-5302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLD456133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered