Provider Demographics
NPI:1336661784
Name:CORRELL, MEGAN (CNP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:CORRELL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 114
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023-0114
Mailing Address - Country:US
Mailing Address - Phone:567-204-0419
Mailing Address - Fax:740-775-7855
Practice Address - Street 1:84 CHELSEA DR
Practice Address - Street 2:
Practice Address - City:GRANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43023-1096
Practice Address - Country:US
Practice Address - Phone:567-204-0419
Practice Address - Fax:740-775-7855
Is Sole Proprietor?:No
Enumeration Date:2017-07-07
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.021190363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health