Provider Demographics
NPI:1063663276
Name:WHETSTONE, MEGHANN ELIZABETH (RD)
Entity Type:Individual
Prefix:
First Name:MEGHANN
Middle Name:ELIZABETH
Last Name:WHETSTONE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:MEGHANN
Other - Middle Name:ELIZABETH
Other - Last Name:RICHEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:1234 E DUPONT RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-1545
Mailing Address - Country:US
Mailing Address - Phone:260-373-9700
Mailing Address - Fax:260-373-9740
Practice Address - Street 1:10515 ILLINOIS RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46814-9182
Practice Address - Country:US
Practice Address - Phone:260-373-9200
Practice Address - Fax:260-373-9219
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37001738A133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000633179OtherANTHEM
IN000000633221OtherANTHEM
IN000000588430OtherANTHEM
IN00000633315OtherANTHEM
IN069860SSSSMedicare PIN