Provider Demographics
NPI:1497084289
Name:JUDKINS, SARAH (RD)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:JUDKINS
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:PO BOX 268984
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73126-8984
Mailing Address - Country:US
Mailing Address - Phone:405-760-7094
Mailing Address - Fax:
Practice Address - Street 1:4140 W MEMORIAL RD STE 321
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8300
Practice Address - Country:US
Practice Address - Phone:405-748-4726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-08
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1768133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered