Provider Demographics
NPI:1194216184
Name:BODE, MEGAN JOHNSON (APRN, NP-C)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:JOHNSON
Last Name:BODE
Suffix:
Gender:F
Credentials:APRN, NP-C
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Mailing Address - Street 1:2717 EAST OAKLAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-1843
Mailing Address - Country:US
Mailing Address - Phone:423-926-2358
Mailing Address - Fax:423-926-2680
Practice Address - Street 1:300 LABORATORY ROAD
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830
Practice Address - Country:US
Practice Address - Phone:865-482-7698
Practice Address - Fax:865-774-0306
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-24
Last Update Date:2024-01-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN24288363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily