Provider Demographics
NPI:1053410605
Name:HAYES, SHERYL EILEEN (RD)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:EILEEN
Last Name:HAYES
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:SHERYL
Other - Middle Name:EILEEN
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD
Mailing Address - Street 1:4070 NW 36TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-2989
Mailing Address - Country:US
Mailing Address - Phone:405-945-0612
Mailing Address - Fax:
Practice Address - Street 1:4070 NW 36TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-2989
Practice Address - Country:US
Practice Address - Phone:405-945-0612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLD818133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered