Provider Demographics
NPI:1699101428
Name:MORGAN, CAITLIN SARAH (RDN,LDN)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:SARAH
Last Name:MORGAN
Suffix:
Gender:F
Credentials:RDN,LDN
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:SARAH
Other - Last Name:PETTIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN, LDN
Mailing Address - Street 1:POB #1
Mailing Address - Street 2:30 MEDICAL CENTER BLVD, SUITE 205
Mailing Address - City:UPLAND
Mailing Address - State:PA
Mailing Address - Zip Code:19013
Mailing Address - Country:US
Mailing Address - Phone:610-619-7410
Mailing Address - Fax:
Practice Address - Street 1:30 MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:UPLAND
Practice Address - State:PA
Practice Address - Zip Code:19013
Practice Address - Country:US
Practice Address - Phone:610-619-7410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1063851133V00000X
PADN005237133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered