Healthcare Provider Details

I. General information

NPI: 1700471976
Provider Name (Legal Business Name): MORGAN MASON RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MORGAN CADRETTE RDN, LDN

II. Dates (important events)

Enumeration Date: 03/09/2021
Last Update Date: 03/09/2021
Certification Date: 03/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 MCFARLAND BLVD N
TUSCALOOSA AL
35406-2209
US

IV. Provider business mailing address

9401 CRETE CIR
TUSCALOOSA AL
35406-1015
US

V. Phone/Fax

Practice location:
  • Phone: 205-345-8208
  • Fax: 205-345-8209
Mailing address:
  • Phone: 334-220-2491
  • Fax: 205-344-9992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number2897
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number2897
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code133VN1301X
TaxonomyOncology Nutrition Registered Dietitian
License Number1074947
License Number StateAL
# 4
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1074947
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: