Provider Demographics
NPI:1376244822
Name:MEGHAN COFFEY NUTRITION, LLC
Entity Type:Organization
Organization Name:MEGHAN COFFEY NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LD, CDCES
Authorized Official - Phone:860-428-9456
Mailing Address - Street 1:134 VINTAGE PARK BLVD STE A-670
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-3998
Mailing Address - Country:US
Mailing Address - Phone:860-428-9456
Mailing Address - Fax:
Practice Address - Street 1:134 VINTAGE PARK BLVD STE A-670
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-3998
Practice Address - Country:US
Practice Address - Phone:860-428-9456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Multi-Specialty