Provider Demographics
NPI:1518537083
Name:CONDON, MEAGHAN KATHLEEN (RN)
Entity Type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:KATHLEEN
Last Name:CONDON
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 1:71 FENNO ST APT 1
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02170-3922
Mailing Address - Country:US
Mailing Address - Phone:774-991-0611
Mailing Address - Fax:
Practice Address - Street 1:71 FENNO ST APT 1
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02170-3922
Practice Address - Country:US
Practice Address - Phone:774-991-0611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2326840163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical