Provider Demographics
NPI:1780485938
Name:CORDELL, ASHLEY PRISCILLA (MS, RD, LD)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:PRISCILLA
Last Name:CORDELL
Suffix:
Gender:
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 1:5840 N HIGHWAY 74C
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-5808
Mailing Address - Country:US
Mailing Address - Phone:405-938-6962
Mailing Address - Fax:
Practice Address - Street 1:5840 N HIGHWAY 74C
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-5808
Practice Address - Country:US
Practice Address - Phone:405-938-6962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK86198967133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered