Provider Demographics
NPI:1417555483
Name:MONSRUD, MEGHAN ANNE (FNP-C)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ANNE
Last Name:MONSRUD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14244 HIGHWAY 515 N STE 100
Mailing Address - Street 2:
Mailing Address - City:ELLIJAY
Mailing Address - State:GA
Mailing Address - Zip Code:30536-2029
Mailing Address - Country:US
Mailing Address - Phone:706-698-5433
Mailing Address - Fax:
Practice Address - Street 1:174 HIGHLAND XING S
Practice Address - Street 2:
Practice Address - City:EAST ELLIJAY
Practice Address - State:GA
Practice Address - Zip Code:30540-2347
Practice Address - Country:US
Practice Address - Phone:706-635-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAF05200907363LF0000X
GARN253931363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily