Provider Demographics
NPI:1164571923
Name:MEGARO, JULIE M (NP-C, CNM)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:M
Last Name:MEGARO
Suffix:
Gender:F
Credentials:NP-C, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4542 BONNEY RD STE B
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3867
Mailing Address - Country:US
Mailing Address - Phone:757-965-2476
Mailing Address - Fax:757-562-7989
Practice Address - Street 1:4542 BONNEY RD STE B
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3867
Practice Address - Country:US
Practice Address - Phone:757-965-2476
Practice Address - Fax:757-965-2476
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168815363L00000X, 363LX0001X, 367A00000X, 363LF0000X
MA225148367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA11112OtherACNM CERT
5255691332OtherFMCSA