Provider Demographics
NPI:1013193960
Name:NELL, MEGAN MARIE
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:MARIE
Last Name:NELL
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 1:3 ASTER LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-2314
Mailing Address - Country:US
Mailing Address - Phone:608-516-3560
Mailing Address - Fax:
Practice Address - Street 1:4325 NAKOMA RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-3706
Practice Address - Country:US
Practice Address - Phone:608-271-7321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2946-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist