Provider Demographics
NPI:1306220512
Name:ROBERTS, MEGAN BLAIR (MSN, FNP-C, RN)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:BLAIR
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MSN, FNP-C, RN
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:3000 MEDICAL ARTS ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-3305
Mailing Address - Country:US
Mailing Address - Phone:512-222-1380
Mailing Address - Fax:512-222-1466
Practice Address - Street 1:3000 MEDICAL ARTS ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3305
Practice Address - Country:US
Practice Address - Phone:512-222-1380
Practice Address - Fax:512-222-1466
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX761637163W00000X
TXAP128638363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse