Provider Demographics
NPI:1871355727
Name:CREMINS, MEGAN
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:CREMINS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5540 CENTERVIEW DR
Mailing Address - Street 2:STE 204 PMB 928779
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606
Mailing Address - Country:US
Mailing Address - Phone:919-357-7870
Mailing Address - Fax:
Practice Address - Street 1:3500 PHILEMON AVE APT 537
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28206-2359
Practice Address - Country:US
Practice Address - Phone:919-357-7870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-26
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X, 174H00000X
NCL008555133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty