Provider Demographics
NPI:1538495049
Name:DUFFY, MEGAN (RN)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:DUFFY
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 1:936 NW DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-2603
Mailing Address - Country:US
Mailing Address - Phone:303-489-0694
Mailing Address - Fax:
Practice Address - Street 1:936 NW DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-2603
Practice Address - Country:US
Practice Address - Phone:303-489-0694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200942782RN163W00000X
CO191949163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse