Provider Demographics
NPI:1609047364
Name:WALKER, JASMYN LYNN (RD/LD)
Entity Type:Individual
Prefix:
First Name:JASMYN
Middle Name:LYNN
Last Name:WALKER
Suffix:
Gender:F
Credentials:RD/LD
Other - Prefix:
Other - First Name:JASMYN
Other - Middle Name:LYNN
Other - Last Name:GEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD/LD
Mailing Address - Street 1:PO BOX 268838
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73126-8838
Mailing Address - Country:US
Mailing Address - Phone:918-619-4400
Mailing Address - Fax:918-619-4801
Practice Address - Street 1:4444 E 41ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2527
Practice Address - Country:US
Practice Address - Phone:918-619-4400
Practice Address - Fax:918-619-4801
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKRD 963490133V00000X
OK1581133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered