Provider Demographics
NPI:1477392264
Name:BAUMLER, MEGAN D (RDN, PHD)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:D
Last Name:BAUMLER
Suffix:
Gender:F
Credentials:RDN, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6183 PARTRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55110-1061
Mailing Address - Country:US
Mailing Address - Phone:608-669-4234
Mailing Address - Fax:
Practice Address - Street 1:5045 DIVISION AVE
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-2663
Practice Address - Country:US
Practice Address - Phone:651-653-2923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4145133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered