MRS. TANYA R HUMPHREY (NPI# 1750923637) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750923637 |
| Entity Type | Individual |
| Full Name | MRS. TANYA R HUMPHREY |
| Credential | BS, NDTR |
| Practice Address |
12 Buffalo Pl Burneyville OK 73430-2136 |
| Practice Telephone | 5802769003 |
| Mailing Telephone | 5802769003 |
| Enumeration Date | 2019-10-12 |
| Last Update Date | 2019-10-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 136A00000X | Dietetic Technician, Registered | Dietary & Nutritional Service Providers |
| Street Address |
12 BUFFALO PL |
| City | BURNEYVILLE |
| State | OK |
| Zip Code | 73430-2136 |
| Taxonomy Code | 136A00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietetic Technician, Registered |
| A person trained in food and nutrition who is an integral part of health care and foodservice management teams. A dietetic technician, registered (DTR) has successfully completed at least a two-year associate’s degree at a US regionally accredited college or university; a dietetic technician program approved by The American Dietetic Association, including 450 hours of supervised practice experience; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Dietetic Technician, Registered -- a food and nutrition practitioner. Chicago, IL: The American dietetic association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508078726 | Patsy Ann Kates | Dietetic Technician, Registered | 20122 North Tamaha Road, Stigler, OK 74462 | 2007-05-03 |
| 1720685852 | Dessirea Knox | Dietetic Technician, Registered | 224 S Chestnut Ave, Moore, OK 73160-5223 | 2020-10-01 |
| 1043841893 | Cody Werneburg | Dietetic Technician, Registered | 3300 Healthplex Pkwy, Norman, OK 73072-9749 | 2020-01-30 |
| 1083069009 | Erin Endress | Dietetic Technician, Registered | 3712 E 11th St, Tulsa, OK 74112-3952 | 2016-04-27 |
| City | BURNEYVILLE |
| Zip Code | 73430 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.