Provider Demographics
NPI:1467113738
Name:KOWALSKI, MEGGAN (BSN, RN, MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:MEGGAN
Middle Name:
Last Name:KOWALSKI
Suffix:
Gender:F
Credentials:BSN, RN, MSN, FNP-C
Other - Prefix:
Other - First Name:MEGGAN VIOLA
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1309 W 17TH ST STE 101
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-8805
Practice Address - Country:US
Practice Address - Phone:605-237-8449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-07
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDF07210098363LF0000X
SDCP002291363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily