Provider Demographics
NPI:1225519325
Name:CARPENTER, MORGAN (MS, RDN/LDN, RN)
Entity Type:Individual
Prefix:MS
First Name:MORGAN
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:MS, RDN/LDN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 ROGERS AVE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23664-1536
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:USAF-OHWS PERFORMANCE RD
Practice Address - Street 2:205 SWEENEY BLVD
Practice Address - City:HAMPTON
Practice Address - State:AA
Practice Address - Zip Code:23665
Practice Address - Country:US
Practice Address - Phone:757-225-9676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV39356-DI-O133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered