Provider Demographics
NPI:1053432963
Name:ALP, KIMBERLY ANN (RD, LD, MBA)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:ANN
Last Name:ALP
Suffix:
Gender:F
Credentials:RD, LD, MBA
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:ANN
Other - Last Name:KLUNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD, MBA
Mailing Address - Street 1:7138 E 86TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5025
Mailing Address - Country:US
Mailing Address - Phone:918-523-5036
Mailing Address - Fax:
Practice Address - Street 1:6161 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1902
Practice Address - Country:US
Practice Address - Phone:918-494-4154
Practice Address - Fax:918-494-7270
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLD654133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered