Provider Demographics
NPI:1700024114
Name:ALFORD-DURBIN, KATHY LUANN (RD/LD)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:LUANN
Last Name:ALFORD-DURBIN
Suffix:
Gender:F
Credentials:RD/LD
Other - Prefix:MRS
Other - First Name:KATHY
Other - Middle Name:LUANN
Other - Last Name:DURBIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD/LD
Mailing Address - Street 1:800 W FORREST AVE
Mailing Address - Street 2:
Mailing Address - City:EUFAULA
Mailing Address - State:OK
Mailing Address - Zip Code:74432-3249
Mailing Address - Country:US
Mailing Address - Phone:918-689-2540
Mailing Address - Fax:918-618-2164
Practice Address - Street 1:800 W FORREST AVE
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:OK
Practice Address - Zip Code:74432-3249
Practice Address - Country:US
Practice Address - Phone:918-689-2540
Practice Address - Fax:918-618-2164
Is Sole Proprietor?:No
Enumeration Date:2009-01-23
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK800133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered