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General NPI Number Information
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NPI Number | 1255060703
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Entity Type | Individual
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Provider Name | MEGAN ELIZABETH KONIC MS, RDN, LD
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Gender | Female
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Dates
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Enumeration Date | 06/09/2022
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Last Update Date | 06/09/2022
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Provider Practice Location Address
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Address Line | 95 ARCH ST
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City | AKRON
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State | OH
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Zip | 44304-1437
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Country | US
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Telephone | 330-375-6590
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Fax | 330-375-6593
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Provider Business Mailing Address
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Address Line | 5120 QUAIL HILL ST NW APT B
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City | NORTH CANTON
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State | OH
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Zip | 44720-7256
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Country | US
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Telephone | 330-319-9379
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | LD.09064
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License Number State | OH
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