Provider Demographics
NPI:1548644388
Name:YAUK, LINDA (MS, RD/LD, CDE)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:YAUK
Suffix:
Gender:F
Credentials:MS, RD/LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-5737
Mailing Address - Country:US
Mailing Address - Phone:580-249-4104
Mailing Address - Fax:580-249-4195
Practice Address - Street 1:401 S 3RD ST
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-5737
Practice Address - Country:US
Practice Address - Phone:580-249-4104
Practice Address - Fax:580-249-4195
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-10
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLD707133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered