Basic Information
Provider Information
NPI: 1558950857
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARKINS
FirstName: MEAGHAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RDN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 IRVING ST NW
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200103017
CountryCode: US
TelephoneNumber: 2028770333
FaxNumber:  
Practice Location
Address1: 110 IRVING ST NW
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200103017
CountryCode: US
TelephoneNumber: 2028770546
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/12/2021
LastUpdateDate: 08/31/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
133V00000XDI100001146DCN Dietary & Nutritional Service ProvidersDietitian, Registered 
133V00000XDX4906MDN Dietary & Nutritional Service ProvidersDietitian, Registered 
133V00000X86066778 Y Dietary & Nutritional Service ProvidersDietitian, Registered 

No ID Information.


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