Provider Demographics
NPI:1316246010
Name:GIVAN, MEGAN ELAINE (RD AND LD)
Entity type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:ELAINE
Last Name:GIVAN
Suffix:
Gender:F
Credentials:RD AND LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 STATE ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-2648
Mailing Address - Country:US
Mailing Address - Phone:270-781-8039
Mailing Address - Fax:
Practice Address - Street 1:1109 STATE ST
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-2648
Practice Address - Country:US
Practice Address - Phone:270-781-8039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2339133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered