Provider Demographics
NPI:1376883793
Name:RICHARDSON, MEGAN KATHLEEN (APRN)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:KATHLEEN
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1248 FARMINGTON AVE
Mailing Address - Street 2:APT. C19
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2609
Mailing Address - Country:US
Mailing Address - Phone:860-922-7000
Mailing Address - Fax:
Practice Address - Street 1:1248 FARMINGTON AVE
Practice Address - Street 2:APT. C19
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2609
Practice Address - Country:US
Practice Address - Phone:860-922-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005199363LN0000X, 363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
No363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal