Provider Demographics
NPI:1003382730
Name:NAQUIN, MEGAN (MS, RD)
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:
Last Name:NAQUIN
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 ATWELLS AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-1517
Mailing Address - Country:US
Mailing Address - Phone:480-459-6282
Mailing Address - Fax:
Practice Address - Street 1:439 BENEFIT ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-2934
Practice Address - Country:US
Practice Address - Phone:401-262-0841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-20
Last Update Date:2018-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI86087633133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered