Provider Demographics
NPI:1205071586
Name:KINNEY, DANNA MICHELLE (MS, RD/LD)
Entity type:Individual
Prefix:MRS
First Name:DANNA
Middle Name:MICHELLE
Last Name:KINNEY
Suffix:
Gender:F
Credentials:MS, RD/LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 STONEBRIDGE BLVD
Mailing Address - Street 2:#428
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-4606
Mailing Address - Country:US
Mailing Address - Phone:918-931-2864
Mailing Address - Fax:
Practice Address - Street 1:157 STONEBRIDGE BLVD
Practice Address - Street 2:#428
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-4606
Practice Address - Country:US
Practice Address - Phone:918-931-2864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1597133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered