Provider Demographics
NPI:1407386774
Name:PANOS, MEGAN JO (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:JO
Last Name:PANOS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:JO
Other - Last Name:LUKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:6010 MILLS CIVIC PKWY #100
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266
Mailing Address - Country:US
Mailing Address - Phone:515-221-7800
Mailing Address - Fax:515-221-7801
Practice Address - Street 1:6010 MILLS CIVIC PKWY STE 100
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8345
Practice Address - Country:US
Practice Address - Phone:515-221-7800
Practice Address - Fax:515-221-7801
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA133844363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care