Provider Demographics
NPI:1275022493
Name:COPELAND, MEGAN (MS, CNS, LDN)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:COPELAND
Suffix:
Gender:F
Credentials:MS, CNS, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 173
Mailing Address - Street 2:
Mailing Address - City:FRIENDSHIP
Mailing Address - State:MD
Mailing Address - Zip Code:20758-0173
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:390 SANSBURY RD
Practice Address - Street 2:
Practice Address - City:FRIENDSHIP
Practice Address - State:MD
Practice Address - Zip Code:20758-9714
Practice Address - Country:US
Practice Address - Phone:301-643-7507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-02
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX4376133VN1006X
MD17319133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic