Provider Demographics
NPI:1437695699
Name:COPPENBARGER, ERIN ELIZABETH (MS, RD/LD, CLC)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:ELIZABETH
Last Name:COPPENBARGER
Suffix:
Gender:F
Credentials:MS, RD/LD, CLC
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:ELIZABETH
Other - Last Name:STRAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LMNT, CLC
Mailing Address - Street 1:500 SW 44TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-3540
Mailing Address - Country:US
Mailing Address - Phone:405-632-6688
Mailing Address - Fax:405-232-0716
Practice Address - Street 1:500 SW 44TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3540
Practice Address - Country:US
Practice Address - Phone:405-632-6688
Practice Address - Fax:405-232-0716
Is Sole Proprietor?:No
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2131133V00000X
NE220455174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174N00000XOther Service ProvidersLactation Consultant, Non-RN