Doctor Name: | MRS. SHANNON MUCKENFUSS |
NPI Number: | 1437577210 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD, LDN, CDE |
License Number: | L002479 |
Business Practice Address: | 165 S Trade St Ste 2c Matthews, NC - 281055771 |
Business Phone Number: | 7048467105 |
Business Fax Number: | 7042466808 |
Mailing Address: | 1036 Hunters Run Dr, TEGA CAY |
State: | SC |
Postal Code: | 297088339 |
Phone Number: | 8034486147 |
Fax Number: | |
NPI Enumeration Date: | 03/31/2014 |
NPI Last Update Date: | 03/31/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | L002479 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |