Provider Demographics
NPI:1497463723
Name:GOOD, MEAGAN
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:GOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4613 WENTWORTH DR
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-1957
Mailing Address - Country:US
Mailing Address - Phone:402-929-0598
Mailing Address - Fax:
Practice Address - Street 1:1259 SETTLERS CREEK PL
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-8147
Practice Address - Country:US
Practice Address - Phone:605-391-3272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider