Provider Demographics
NPI:1285381871
Name:MERRELLS, MEGAN NOELLE (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:NOELLE
Last Name:MERRELLS
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:NOELLE
Other - Last Name:CHAFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7920 BAKER RD SW
Mailing Address - Street 2:
Mailing Address - City:STOUTSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43154-9529
Mailing Address - Country:US
Mailing Address - Phone:740-248-1558
Mailing Address - Fax:
Practice Address - Street 1:8001 RAVINES EDGE CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-5423
Practice Address - Country:US
Practice Address - Phone:888-364-5977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.09603133V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program