Provider Demographics
NPI:1356651400
Name:ANDERSON, MEAGAN SUE (RN)
Entity Type:Individual
Prefix:MRS
First Name:MEAGAN
Middle Name:SUE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:6411 N. ROBERT RD., RM 916
Mailing Address - Street 2:HUMBOLDT UNIFIED SCHOOL DISTRICT #22/SSO
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314
Mailing Address - Country:US
Mailing Address - Phone:928-759-4042
Mailing Address - Fax:428-759-4030
Practice Address - Street 1:6411 N. ROBERT RD., RM 916
Practice Address - Street 2:HUMBOLDT UNIFIED SCHOOL DISTRICT #22/SSO
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314
Practice Address - Country:US
Practice Address - Phone:928-759-4042
Practice Address - Fax:428-759-4030
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZRN152704163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool