Provider Demographics
NPI:1265190052
Name:EISENBEIS, MEGAN ELIZABETH (MS, RD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:EISENBEIS
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:MRS
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:EISENVOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, RD
Mailing Address - Street 1:713 S MABLE AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-2252
Mailing Address - Country:US
Mailing Address - Phone:605-610-5358
Mailing Address - Fax:
Practice Address - Street 1:4101 W 38TH ST STE 102
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-0725
Practice Address - Country:US
Practice Address - Phone:605-367-5358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist