Provider Demographics
NPI:1033149489
Name:ALAN, MEAGAN KATHRYN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MEAGAN
Middle Name:KATHRYN
Last Name:ALAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:MEAGAN
Other - Middle Name:KATHRYN
Other - Last Name:RENNINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1803 MOUNT ROSE AVE
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3026
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-812-2495
Practice Address - Street 1:1001 S GEORGE ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3676
Practice Address - Country:US
Practice Address - Phone:717-851-4005
Practice Address - Fax:717-812-2495
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA000481L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1551066OtherGATEWAY MEDICARE ASSURED
PA1983371OtherHIGHMARK BLUE SHIELD
PA1551066OtherGATEWAY-WMG
PA970017885Medicare PIN
PA1551066OtherGATEWAY MEDICARE ASSURED
PA237823FLTMedicare PIN
PA042427Medicare PIN