Provider Demographics
NPI:1033441563
Name:SKAKUN, MEGHAN R (APN)
Entity Type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:R
Last Name:SKAKUN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:F
Other - Last Name:REID
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APN
Mailing Address - Street 1:130 S BRYN MAWR AVE
Mailing Address - Street 2:BRYN MAWR HOSPITAL
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3121
Mailing Address - Country:US
Mailing Address - Phone:484-337-4618
Mailing Address - Fax:484-337-4661
Practice Address - Street 1:130 S BRYN MAWR AVE
Practice Address - Street 2:BRYN MAWR HOSPITAL
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3121
Practice Address - Country:US
Practice Address - Phone:484-337-4618
Practice Address - Fax:484-337-4661
Is Sole Proprietor?:No
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN611830363L00000X
PASPO10688363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner