Provider Demographics
NPI:1548412380
Name:ALLEN, REBECCA ANN (RD/LD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RD/LD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ANN
Other - Last Name:MILLIGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 CHILDREN'S AVENUE, SUITE 4500
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5008
Mailing Address - Country:US
Mailing Address - Phone:405-271-6764
Mailing Address - Fax:405-271-3093
Practice Address - Street 1:1200 CHILDRENS AVE STE 4500
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-4637
Practice Address - Country:US
Practice Address - Phone:405-271-6764
Practice Address - Fax:405-271-3093
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK962532133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered