Gabriel Cannon, R.D.N.
Individual provider Active NPI Registered Dietitian · Blanchard, OK
NPI 1326595703 · NPPES record last updated Sep 2, 2016
Key facts
- NPI
- 1326595703
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 2126 (OK)
- Practice address
- 326 N Madison Ave
Blanchard, OK 73010-5929 - Phone
- (405) 413-7456
- NPI assigned
- Sep 2, 2016
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2126 | OK | MD | Nutritionist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 2126 | OK | |
| Registered Dietitian | 133V00000X | 2126 | OK | Yes |
Addresses
Primary practice location
326 N Madison Ave
Blanchard, OK 73010-5929
Mailing address
326 N Madison Ave
Blanchard, OK 73010-5929
Phone (405) 413-7456
Other providers in Blanchard, OK
- Brant D. Spencer D.C. P.C.
- Cassie Jo Brown
- Tyler Adam Brown
- Brooklyne N. Brumley
- Leslie Diane Butler
- Courtney Leann Carothers
- Deborah A Charlton
- Martin Edward Christensen
- Christina Richardson
- Ashlee Lynn Cvikel
All providers in Blanchard, OK · Registered Dietitian in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.