Provider Demographics
NPI:1093131922
Name:MCELROY, MEGAN (CNP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MCELROY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:ARCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 449
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-0449
Mailing Address - Country:US
Mailing Address - Phone:740-374-4500
Mailing Address - Fax:740-374-5887
Practice Address - Street 1:320 E. EIGHTH ST.
Practice Address - Street 2:SUITE 141
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-1656
Practice Address - Country:US
Practice Address - Phone:740-374-5580
Practice Address - Fax:740-374-6266
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-17
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.15817-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810027340Medicaid
OH0101623Medicaid
WV3810027340Medicaid
OHH318341Medicare PIN
OHH318340Medicare PIN