Taylor Deacon, RDN, LDN
Individual provider Active NPI Registered Dietitian · Grand Ledge, MI
NPI 1962011395 · NPPES record last updated Aug 23, 2024
Key facts
- NPI
- 1962011395
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 86167503 (MI)
- Practice address
- 1116 Timbercreek Dr Apt 29
Grand Ledge, MI 48837-2306 - Phone
- (517) 526-5368
- NPI assigned
- Jul 31, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86167503 | MI | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86167503 | MI | Yes |
Addresses
Primary practice location
1116 Timbercreek Dr Apt 29
Grand Ledge, MI 48837-2306
Mailing address
14716 Dogwood Dr
Plymouth, MI 48170-2700
Phone (517) 526-5368
Other names
- Taylor Wilcox
Other providers in Grand Ledge, MI
- Hannah Dankert
- Melinda Darcangelo
- David J Harkema DMD
- David J Harkema DMD
- David J. Smith MD PC
- Jami M Devarona
- Mary Elizabeth Dion
- Eleanor Dionise
- Divine Mind Consultation Services
- Cassandra Dowker
All providers in Grand Ledge, MI · Registered Dietitian in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.