Provider Demographics
NPI:1225414378
Name:WILLS, MEGAN SCULLY (NP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:SCULLY
Last Name:WILLS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:LYNN
Other - Last Name:SCULLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:NEWTON WELLESLEY
Mailing Address - Street 2:2014 WASHINGTON ST
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462
Mailing Address - Country:US
Mailing Address - Phone:617-243-5205
Mailing Address - Fax:
Practice Address - Street 1:NEWTON WELLESLEY HOSPITAL
Practice Address - Street 2:2014 WASHINGTON ST
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462
Practice Address - Country:US
Practice Address - Phone:617-243-5205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95002054363LW0102X
MA270701363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health