Provider Demographics
NPI:1942908637
Name:HUGHEY, MEG LAUREN HEFFNER
Entity type:Individual
Prefix:
First Name:MEG
Middle Name:LAUREN HEFFNER
Last Name:HUGHEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-6519
Mailing Address - Country:US
Mailing Address - Phone:410-746-2316
Mailing Address - Fax:
Practice Address - Street 1:216 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-6519
Practice Address - Country:US
Practice Address - Phone:410-746-2316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR228098163WN1003X
133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support