Provider Demographics
NPI:1174194286
Name:HAYES, KATE MARIE (RDN/LD)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:MARIE
Last Name:HAYES
Suffix:
Gender:F
Credentials:RDN/LD
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:MARIE
Other - Last Name:WILDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2673 BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-5062
Mailing Address - Country:US
Mailing Address - Phone:405-464-8884
Mailing Address - Fax:
Practice Address - Street 1:2673 BRENTWOOD DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-5062
Practice Address - Country:US
Practice Address - Phone:405-464-8884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2414133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered