Provider Demographics
NPI:1144890070
Name:CASEY, MEGAN M (RD, LDN, CSOWM)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:M
Last Name:CASEY
Suffix:
Gender:F
Credentials:RD, LDN, CSOWM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 ORMOND VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:DESTREHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70047-3716
Mailing Address - Country:US
Mailing Address - Phone:504-471-5250
Mailing Address - Fax:
Practice Address - Street 1:4720 S I 10 SERVICE RD W
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-7404
Practice Address - Country:US
Practice Address - Phone:504-988-2274
Practice Address - Fax:504-988-1936
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA86117106133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered