Provider Demographics
NPI:1831268242
Name:MEARNS, ROBERTA DEGROODT (RD LD CDE)
Entity type:Individual
Prefix:MRS
First Name:ROBERTA
Middle Name:DEGROODT
Last Name:MEARNS
Suffix:
Gender:F
Credentials:RD LD CDE
Other - Prefix:
Other - First Name:BOBBIE
Other - Middle Name:DEGROODT
Other - Last Name:MEARNS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD LD CDE
Mailing Address - Street 1:THE NUTRITIVE EDGE
Mailing Address - Street 2:34 PANEPINTO DRIVE
Mailing Address - City:SCHWENKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19473
Mailing Address - Country:US
Mailing Address - Phone:610-246-0656
Mailing Address - Fax:
Practice Address - Street 1:THE NUTRITIVE EDGE
Practice Address - Street 2:34 PANEPINTO DRIVE
Practice Address - City:SCHWENKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19473
Practice Address - Country:US
Practice Address - Phone:610-246-0656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN001314133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic