Marjorie Redan, R.D., L.D.N.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DN000412 Issued in PA

Practice address

324 Woodland Way
Tunkhannock, PA 18657-8031

Phone

(570) 836-4669

NPI assigned

Dec 28, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1356652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356652800000",
    "number": "1740526490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 WOODLAND WAY",
            "city": "TUNKHANNOCK",
            "state": "PA",
            "postal_code": "186578031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 WOODLAND WAY",
            "city": "TUNKHANNOCK",
            "state": "PA",
            "postal_code": "186578031",
            "telephone_number": "570-836-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDAN",
        "first_name": "MARJORIE",
        "credential": "R.D., L.D.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-28",
        "last_updated": "2012-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN000412",
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "PA",
            "license": "DN000412",
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "PA",
            "license": "DN000412",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Tunkhannock, PA
• Providers in Tunkhannock, PA by specialty
• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.