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Contact Information

ANDREA D SHOTTON, MS RD LD
21333 E 104TH ST
BROKEN ARROW, OK74014
 Phone: 918-449-1123
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
 

Nutritionist

133N00000X
Indicates primary specialty

NPI Profile & details for ANDREA D SHOTTON · (Female)

NPI Number 1184851255
Status Active
Credentials MS RD LD
Entity Individual
Enumeration date 06/16/2009
Last updated 02/12/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • OK License # 1659
  • TN License # 1371
  • MS Medicaid 05376085
  • OK Medicaid 200255350 B
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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