Provider Demographics
NPI:1376380907
Name:MORAN, MEGAN MILLER (RD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MILLER
Last Name:MORAN
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 1:17 SELDEN AVE
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-5534
Mailing Address - Country:US
Mailing Address - Phone:203-500-9106
Mailing Address - Fax:
Practice Address - Street 1:17 SELDEN AVE
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-5534
Practice Address - Country:US
Practice Address - Phone:203-500-9106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered