Provider Demographics
NPI:1922852383
Name:MEEBOER, LYNN (RD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:MEEBOER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7205 GODDARD DR
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-4475
Mailing Address - Country:US
Mailing Address - Phone:614-832-5406
Mailing Address - Fax:
Practice Address - Street 1:7205 GODDARD DR
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-4475
Practice Address - Country:US
Practice Address - Phone:614-832-5406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered