Healthcare Provider Details

I. General information

NPI: 1619794518
Provider Name (Legal Business Name): MORGAN KRUPP MD, RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 09/23/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 SOUTH LAMAR BOULEVARD SOUTH OXFORD CENTER, SUITE NW 1350
UNIVERSITY MS
38677
US

IV. Provider business mailing address

2301 SOUTH LAMAR BOULEVARD SOUTH OXFORD CENTER, SUITE NW 1350
UNIVERSITY MS
38677
US

V. Phone/Fax

Practice location:
  • Phone: 662-915-8662
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: