Provider Demographics
NPI:1720896525
Name:PRATHER, MEGAN (RDN, LDN)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:PRATHER
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1158 N UNION GROVE RD
Mailing Address - Street 2:
Mailing Address - City:FRIENDSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37737-2522
Mailing Address - Country:US
Mailing Address - Phone:865-607-1646
Mailing Address - Fax:
Practice Address - Street 1:3028 OLD NILES FERRY RD
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37803-0530
Practice Address - Country:US
Practice Address - Phone:980-855-1865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3761133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered