Healthcare Provider Details

I. General information

NPI: 1275084782
Provider Name (Legal Business Name): MEGAN ASHLEY CALLAHAN RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2016
Last Update Date: 03/24/2022
Certification Date: 02/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 N 11TH ST
GRAND JUNCTION CO
81501-8102
US

IV. Provider business mailing address

PO BOX 63362
CHARLOTTE NC
28263-3362
US

V. Phone/Fax

Practice location:
  • Phone: 970-298-6400
  • Fax:
Mailing address:
  • Phone: 919-620-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License NumberL004969
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL004969
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: