Healthcare Provider Details

I. General information

NPI: 1285381871
Provider Name (Legal Business Name): MEGAN NOELLE MERRELLS MS, RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN NOELLE CHAFIN

II. Dates (important events)

Enumeration Date: 03/03/2022
Last Update Date: 11/24/2023
Certification Date: 11/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8001 RAVINES EDGE CT
COLUMBUS OH
43235-5423
US

IV. Provider business mailing address

7920 BAKER RD SW
STOUTSVILLE OH
43154-9529
US

V. Phone/Fax

Practice location:
  • Phone: 888-364-5977
  • Fax:
Mailing address:
  • Phone: 740-248-1558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD.09603
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: