Provider Demographics
NPI:1164515979
Name:GALLIART, KARI ELIZABETH (RD)
Entity Type:Individual
Prefix:MS
First Name:KARI
Middle Name:ELIZABETH
Last Name:GALLIART
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4109 W PHEASANT RDG
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-5034
Mailing Address - Country:US
Mailing Address - Phone:405-372-8643
Mailing Address - Fax:
Practice Address - Street 1:4109 W PHEASANT RDG
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-5034
Practice Address - Country:US
Practice Address - Phone:405-372-8643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLD624133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered