Provider Demographics
NPI:1427573542
Name:RIPPERGER, MEGAN RENEE (MS, RD, CSSD, LD)
Entity type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:RENEE
Last Name:RIPPERGER
Suffix:
Gender:F
Credentials:MS, RD, CSSD, LD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:RENEE
Other - Last Name:KWON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, CSSD, LD
Mailing Address - Street 1:6600 VAN AALST BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MOORE
Mailing Address - State:GA
Mailing Address - Zip Code:31905-2102
Mailing Address - Country:US
Mailing Address - Phone:627-408-2273
Mailing Address - Fax:
Practice Address - Street 1:6600 VAN AALST BLVD
Practice Address - Street 2:
Practice Address - City:FORT MOORE
Practice Address - State:GA
Practice Address - Zip Code:31905-2102
Practice Address - Country:US
Practice Address - Phone:762-408-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD004915133VN1501X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics