Provider Demographics
NPI:1891834644
Name:MEYERS, KAREN DANETTE (RD)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:DANETTE
Last Name:MEYERS
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 1:124 LAKEVIEW CT
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-3079
Mailing Address - Country:US
Mailing Address - Phone:405-613-0518
Mailing Address - Fax:405-285-7469
Practice Address - Street 1:124 LAKEVIEW CT
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-3079
Practice Address - Country:US
Practice Address - Phone:405-613-0518
Practice Address - Fax:405-285-7469
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLD909133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered