Provider Demographics
NPI:1497187520
Name:MORGAN, CAITLIN MARIE (RD, LDN)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:MARIE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:RD, 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 846
Mailing Address - Street 2:53 DARBY ROAD
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-0846
Mailing Address - Country:US
Mailing Address - Phone:610-644-5870
Mailing Address - Fax:610-647-3751
Practice Address - Street 1:53 DARBY RD
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1415
Practice Address - Country:US
Practice Address - Phone:610-644-5870
Practice Address - Fax:610-647-3751
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004952133V00000X
DEDN-0000510133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered