Provider Demographics
NPI:1073097747
Name:ECKLEBERRY, MEGAN (ACCNSAG)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:ECKLEBERRY
Suffix:
Gender:F
Credentials:ACCNSAG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WVU HEART & VASCULAR INSTITUTE - SE TOWER
Mailing Address - Street 2:1 MEDICAL CENTER DR
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506-1200
Mailing Address - Country:US
Mailing Address - Phone:877-988-4478
Mailing Address - Fax:
Practice Address - Street 1:WVU HEART & VASCULAR INSTITUTE - SE TOWER
Practice Address - Street 2:1 MEDICAL CENTER DR
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-1200
Practice Address - Country:US
Practice Address - Phone:877-988-4478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN86885-ACCNS-AG364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology