Provider Demographics
NPI:1033745583
Name:VANDER ZEE, MORGAN TAYLOR (RDN)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:TAYLOR
Last Name:VANDER ZEE
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4805 S TRIBBEY TRL
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-1989
Mailing Address - Country:US
Mailing Address - Phone:605-323-5663
Mailing Address - Fax:
Practice Address - Street 1:4805 S TRIBBEY TRL
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-1989
Practice Address - Country:US
Practice Address - Phone:605-323-5663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0712133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty