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JENNIFER RACHELLE HOLMAN RD/LD-CDE NPI 1417069782


NPI Information

NPI: 1417069782
Provider Name: JENNIFER RACHELLE HOLMAN, RD/LD-CDE
Classification: Dietitian, Registered - 133V00000X
Entity Type: Individual
Address:
408 S CHERRY ST
SALLISAW, OK
ZIP 74955
Phone: (918) 774-5074
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Jennifer Rachelle Holman, RD/LD-CDE is a dietitian registered in Sallisaw, OK. The provider is a Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation. Jennifer Rachelle Holman, RD/LD-CDE NPI is 1417069782. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

408 S CHERRY ST
SALLISAW, OK
ZIP 74955-602
Phone: (918) 774-5074

The enumeration date for this NPI number is 8/31/2006 and was last updated on 8/23/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1133V00000XDietitian, RegisteredLD1057OKLAHOMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200057610AMEDICAIDOKLAHOMA
28E279BOTHEROKLAHOMAPART B
3200057610BOTHEROKLAHOMAOHCA DDSD WAIVER
4P58904MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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