Healthcare Provider Details

I. General information

NPI: 1316786122
Provider Name (Legal Business Name): MEGAN KATHLINE WALKER RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN KATHLINE WALKER RDN

II. Dates (important events)

Enumeration Date: 05/21/2024
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10098 COUNTRY MANOR DR
PEYTON CO
80831-7164
US

IV. Provider business mailing address

4102 PINION DR
USAF ACADEMY CO
80840-2502
US

V. Phone/Fax

Practice location:
  • Phone: 204-215-4727
  • Fax:
Mailing address:
  • Phone: 719-524-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86277819
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: