Provider Demographics
NPI:1427573542
Name:KWON, MEGAN RENEE (MS, RD, LD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:RENEE
Last Name:KWON
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:RENEE
Other - Last Name:RIPPERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4343 WARM SPRINGS RD APT 110
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-5903
Mailing Address - Country:US
Mailing Address - Phone:515-229-7355
Mailing Address - Fax:
Practice Address - Street 1:4343 WARM SPRINGS ROAD APT. 110
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909
Practice Address - Country:US
Practice Address - Phone:515-229-7355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD004915133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered