Sarah Jennette Berry, R.D.

Individual provider Active NPI Registered Dietitian · Owasso, OK

NPI 1104018266 · NPPES record last updated Feb 10, 2012

Key facts

NPI
1104018266
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
1550 (OK)
Practice address
10306 N 138TH East Ave
Owasso, OK 74055-4665
Phone
(918) 401-0006
Fax
(877) 380-4628
NPI assigned
Aug 13, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
516OKMDPsychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1550 OK Yes
Registered Dietitian 133V00000X 516 OK

Addresses

Primary practice location

10306 N 138TH East Ave
Owasso, OK 74055-4665

Mailing address

10746 E 120TH CT N
Collinsville, OK 74021-5542
Phone (918) 401-0006

Other identifiers

IdentifierTypeStateIssuer
200117350CMedicaidOK

Other providers in Owasso, OK

All providers in Owasso, OK · Registered Dietitian in Oklahoma

Sources for this page

Verify at the official NPI Registry.