Provider Demographics
NPI:1093060915
Name:PARRIOTT, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:PARRIOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W MAPLE AVE
Mailing Address - Street 2:SUITE 510
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-4054
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:205 W MAPLE AVE
Practice Address - Street 2:SUITE 510
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-4054
Practice Address - Country:US
Practice Address - Phone:580-237-4680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1866133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered