MEDICARE: MEGAN PATE RDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1649071754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN PATE RDN

Provider Business Mailing Address
First Line	:	185 TREASURE LN
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-7816
Country	:	US
Telephone Number	:	423-297-4145
Fax Number	:

Provider Business Practice Location Address
First Line	:	185 TREASURE LN
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-7816
Country	:	US
Telephone Number	:	423-297-4145
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2025
Last Update Date	:	03/24/2025

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