Provider Demographics
NPI:1184950727
Name:PATTEN, MEGAN (RD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:PATTEN
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 1:235 MAIN ST
Mailing Address - Street 2:PO BOX 685
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-2411
Mailing Address - Country:US
Mailing Address - Phone:207-283-7680
Mailing Address - Fax:
Practice Address - Street 1:235 MAIN ST
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-2411
Practice Address - Country:US
Practice Address - Phone:207-283-7680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-01
Last Update Date:2009-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDI916133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered