Provider Demographics
NPI:1235839101
Name:BIVENS, MEGAN RENEE
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:RENEE
Last Name:BIVENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT ORAB
Mailing Address - State:OH
Mailing Address - Zip Code:45154-6501
Mailing Address - Country:US
Mailing Address - Phone:937-444-6127
Mailing Address - Fax:937-444-6192
Practice Address - Street 1:709 N HIGH ST
Practice Address - Street 2:
Practice Address - City:MOUNT ORAB
Practice Address - State:OH
Practice Address - Zip Code:45154-6501
Practice Address - Country:US
Practice Address - Phone:937-444-6127
Practice Address - Fax:937-444-6192
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator