Provider Demographics
NPI:1992468276
Name:CRAIN, MEGAN KATHRYN (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:KATHRYN
Last Name:CRAIN
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:SHAUGHNESSY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8901 CARTI WAY
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6523
Mailing Address - Country:US
Mailing Address - Phone:501-906-3000
Mailing Address - Fax:
Practice Address - Street 1:8901 CARTI WAY
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6523
Practice Address - Country:US
Practice Address - Phone:501-906-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1726133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered