Provider Demographics
NPI:1467412940
Name:BLEX, MEGGIN MARIE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MEGGIN
Middle Name:MARIE
Last Name:BLEX
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:COFFEYVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67337-3307
Mailing Address - Country:US
Mailing Address - Phone:620-251-2400
Mailing Address - Fax:620-251-1619
Practice Address - Street 1:1505 W 4TH ST
Practice Address - Street 2:
Practice Address - City:COFFEYVILLE
Practice Address - State:KS
Practice Address - Zip Code:67337-3307
Practice Address - Country:US
Practice Address - Phone:620-251-2400
Practice Address - Fax:620-251-1619
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44138207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200262920CMedicaid