Provider Demographics
NPI:1417310376
Name:CARTWRIGHT, JENNIFER CHRISTINE (MS, RD/LD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CHRISTINE
Last Name:CARTWRIGHT
Suffix:
Gender:F
Credentials:MS, RD/LD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:ROACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 N PORTER AVE
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-6404
Mailing Address - Country:US
Mailing Address - Phone:405-307-1000
Mailing Address - Fax:405-307-1304
Practice Address - Street 1:901 N PORTER AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6404
Practice Address - Country:US
Practice Address - Phone:405-307-1000
Practice Address - Fax:405-307-1304
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLD 2156133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1417310376OtherNPI