Provider Demographics
NPI:1235883554
Name:REMEDIOS, MEGEAN ELAINE (FNP-C)
Entity Type:Individual
Prefix:
First Name:MEGEAN
Middle Name:ELAINE
Last Name:REMEDIOS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 COUNTY ROAD 438
Mailing Address - Street 2:
Mailing Address - City:IUKA
Mailing Address - State:MS
Mailing Address - Zip Code:38852-6737
Mailing Address - Country:US
Mailing Address - Phone:601-433-9790
Mailing Address - Fax:
Practice Address - Street 1:4 COUNTY ROAD 438
Practice Address - Street 2:
Practice Address - City:IUKA
Practice Address - State:MS
Practice Address - Zip Code:38852-6737
Practice Address - Country:US
Practice Address - Phone:601-433-9790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-06
Last Update Date:2022-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSGRAY-QYSJMV363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily