Provider Demographics
NPI:1073349346
Name:KNUST, MORGAN G (LMNT)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:G
Last Name:KNUST
Suffix:
Gender:F
Credentials:LMNT
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:GURWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 24607
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-0607
Mailing Address - Country:US
Mailing Address - Phone:402-955-5400
Mailing Address - Fax:402-955-3674
Practice Address - Street 1:8552 CASS ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3567
Practice Address - Country:US
Practice Address - Phone:402-955-3871
Practice Address - Fax:402-955-8738
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1787133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric