Provider Demographics
NPI:1548899768
Name:FITE, CARA LYNN (RD, CSG, LD)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:LYNN
Last Name:FITE
Suffix:
Gender:F
Credentials:RD, CSG, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 SW 137TH CT
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-4321
Mailing Address - Country:US
Mailing Address - Phone:720-628-3421
Mailing Address - Fax:
Practice Address - Street 1:310 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-2130
Practice Address - Country:US
Practice Address - Phone:405-733-1891
Practice Address - Fax:405-739-0632
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2007133V00000X
OK86035546133V00000X
OK2460133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered