Provider Demographics
NPI:1972015550
Name:TAUBEL, MORGAN (RDN, LD)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:TAUBEL
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:MCMANIMON-MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN, LD, CD
Mailing Address - Street 1:911 NORTHLAND DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:MN
Mailing Address - Zip Code:55371-2172
Mailing Address - Country:US
Mailing Address - Phone:763-389-6350
Mailing Address - Fax:763-389-6664
Practice Address - Street 1:911 NORTHLAND DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:MN
Practice Address - Zip Code:55371-2172
Practice Address - Country:US
Practice Address - Phone:763-389-6367
Practice Address - Fax:763-389-6664
Is Sole Proprietor?:No
Enumeration Date:2017-11-03
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
MN86029897133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered