Provider Demographics
NPI:1073888376
Name:HENRIE, MEGAN NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:NICOLE
Last Name:HENRIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:NICOLE
Other - Last Name:KUHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:SHIPROCK
Mailing Address - State:NM
Mailing Address - Zip Code:87420-0160
Mailing Address - Country:US
Mailing Address - Phone:505-360-6001
Mailing Address - Fax:505-368-6260
Practice Address - Street 1:HWY 491 NORTH
Practice Address - Street 2:NORTHERN NAVAJO MEDICAL CENTER
Practice Address - City:SHIPROCK
Practice Address - State:NM
Practice Address - Zip Code:87420-0160
Practice Address - Country:US
Practice Address - Phone:505-360-6001
Practice Address - Fax:505-368-6260
Is Sole Proprietor?:No
Enumeration Date:2012-03-20
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2016-0106207V00000X, 207VB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VB0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObesity Medicine
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology