Provider Demographics
NPI:1033590740
Name:WREN, MEGAN L (NP)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:L
Last Name:WREN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:MEGAN
Other - Middle Name:L
Other - Last Name:VOIGTMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:12255 DE PAUL DR. STE 470
Mailing Address - Street 2:
Mailing Address - City:BRDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044
Mailing Address - Country:US
Mailing Address - Phone:314-298-3893
Mailing Address - Fax:314-851-4408
Practice Address - Street 1:12255 DE PAUL DR STE 420N
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2510
Practice Address - Country:US
Practice Address - Phone:314-298-3893
Practice Address - Fax:314-851-4408
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014041446363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1033590740Medicaid