Provider Demographics
NPI:1013980499
Name:HUFFMAN, CHRISTIE ANNE (LD)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:ANNE
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:LD
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:ANNE
Other - Last Name:MOODY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
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:918-660-3632
Mailing Address - Fax:918-660-3631
Practice Address - Street 1:2815 S SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74129
Practice Address - Country:US
Practice Address - Phone:918-619-4300
Practice Address - Fax:918-619-4322
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1040133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered