Provider Demographics
NPI:1083390736
Name:ACOSTA O'GARA, MEGAN KRISTINE
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:KRISTINE
Last Name:ACOSTA O'GARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:846 PARK AVE APT 205
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-2135
Mailing Address - Country:US
Mailing Address - Phone:712-389-2260
Mailing Address - Fax:
Practice Address - Street 1:846 PARK AVE APT 205
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-2135
Practice Address - Country:US
Practice Address - Phone:712-389-2260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program