Provider Demographics
NPI:1184180598
Name:SCURA, MEGHAN (RD, LDN, CLC)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:SCURA
Suffix:
Gender:F
Credentials:RD, LDN, CLC
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:648 GREENRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GLENMOORE
Mailing Address - State:PA
Mailing Address - Zip Code:19343-9500
Mailing Address - Country:US
Mailing Address - Phone:407-790-0063
Mailing Address - Fax:
Practice Address - Street 1:648 GREENRIDGE RD
Practice Address - Street 2:
Practice Address - City:GLENMOORE
Practice Address - State:PA
Practice Address - Zip Code:19343-9500
Practice Address - Country:US
Practice Address - Phone:407-790-0063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN006732133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered