Provider Demographics
NPI:1487203410
Name:FALLER, MEGHAN L (RN)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:L
Last Name:FALLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4230 FAIRWAY DR APT 9204
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-3282
Mailing Address - Country:US
Mailing Address - Phone:314-971-9717
Mailing Address - Fax:
Practice Address - Street 1:4230 FAIRWAY DR APT 9204
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-3282
Practice Address - Country:US
Practice Address - Phone:314-971-9717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX970788163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX970788OtherRN