Provider Demographics
NPI:1548235831
Name:MACINNES, MEGAN (CNM)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MACINNES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MILL ST
Mailing Address - Street 2:STE 204
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-4784
Mailing Address - Country:US
Mailing Address - Phone:781-646-1043
Mailing Address - Fax:781-646-2591
Practice Address - Street 1:22 MILL ST
Practice Address - Street 2:STE 102
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-4784
Practice Address - Country:US
Practice Address - Phone:781-646-1043
Practice Address - Fax:781-646-2591
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA192785176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0354520Medicaid
MA0354520Medicaid
MARN0182Medicare ID - Type Unspecified