Provider Demographics
NPI:1154099679
Name:WESOLOWSKI, MEGHAN ELIZABETH (CRNP)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ELIZABETH
Last Name:WESOLOWSKI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 SPRINGDALE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2834
Mailing Address - Country:US
Mailing Address - Phone:610-524-3703
Mailing Address - Fax:610-524-5990
Practice Address - Street 1:860 SPRINGDALE DR STE 100
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2834
Practice Address - Country:US
Practice Address - Phone:610-524-3703
Practice Address - Fax:610-524-5990
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP024309207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine