Provider Demographics
NPI:1184457830
Name:WHITE, MEGAN MARIE (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:WHITE
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:MARIE
Other - Last Name:PARTACZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LD
Mailing Address - Street 1:3025 KATE BOND RD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-4004
Mailing Address - Country:US
Mailing Address - Phone:901-384-0065
Mailing Address - Fax:
Practice Address - Street 1:3025 KATE BOND RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133-4004
Practice Address - Country:US
Practice Address - Phone:901-384-0065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3672133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered