Provider Demographics
NPI:1760654057
Name:BEREMAN, MEGAN MYERS (RD LDN)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:MYERS
Last Name:BEREMAN
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 1:2074 TORDELO PL
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-4749
Mailing Address - Country:US
Mailing Address - Phone:919-413-8667
Mailing Address - Fax:888-972-4151
Practice Address - Street 1:STUDENT HEALTH SERVICES
Practice Address - Street 2:CAMPUS BOX 7304
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27695-7304
Practice Address - Country:US
Practice Address - Phone:919-513-1578
Practice Address - Fax:888-972-4151
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003119133V00000X, 133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education