Provider Demographics
NPI:1124362991
Name:CHALLACOMBE, MEGAN (PA-C)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:CHALLACOMBE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USS HARRY S TRUMAN CVN75
Mailing Address - Street 2:UNIT 100255 BOX2720
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09524
Mailing Address - Country:US
Mailing Address - Phone:757-443-7882
Mailing Address - Fax:
Practice Address - Street 1:USS HARRY S TRUMAN CVN75
Practice Address - Street 2:UNIT 100255 BOX2720
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09524
Practice Address - Country:US
Practice Address - Phone:757-443-7882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant