Provider Demographics
NPI:1679239651
Name:DEEGAN, BARBARA BRIGITTE (RD, LDN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:BRIGITTE
Last Name:DEEGAN
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 1:479 STOCKHAM AVE
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19067-6616
Mailing Address - Country:US
Mailing Address - Phone:215-450-0448
Mailing Address - Fax:
Practice Address - Street 1:479 STOCKHAM AVE
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:PA
Practice Address - Zip Code:19067-6616
Practice Address - Country:US
Practice Address - Phone:215-450-0448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-13
Last Update Date:2021-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN007595133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered