Provider Demographics
NPI:1205857299
Name:VAN CAMP, MEGHAN MURPHY (RDN, LD, CDE)
Entity type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:MURPHY
Last Name:VAN CAMP
Suffix:
Gender:F
Credentials:RDN, LD, CDE
Other - Prefix:MISS
Other - First Name:MEGHAN
Other - Middle Name:FRANCES
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD/N
Mailing Address - Street 1:5601 NW 72ND ST STE 200
Mailing Address - Street 2:
Mailing Address - City:WARR ACRES
Mailing Address - State:OK
Mailing Address - Zip Code:73132-5920
Mailing Address - Country:US
Mailing Address - Phone:405-603-1941
Mailing Address - Fax:405-603-1942
Practice Address - Street 1:5601 NW 72ND ST STE 200
Practice Address - Street 2:
Practice Address - City:WARR ACRES
Practice Address - State:OK
Practice Address - Zip Code:73132
Practice Address - Country:US
Practice Address - Phone:405-603-1941
Practice Address - Fax:405-603-1942
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1977133V00000X
FLND4278133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
591561574OtherEIN
591561574OtherEIN