Provider Demographics
NPI:1558323048
Name:STRACHAN, MEGAN LEE (BSN)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:LEE
Last Name:STRACHAN
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2703 APOLLO DR
Mailing Address - Street 2:
Mailing Address - City:BARSTOW
Mailing Address - State:CA
Mailing Address - Zip Code:92311-9761
Mailing Address - Country:US
Mailing Address - Phone:760-253-3816
Mailing Address - Fax:
Practice Address - Street 1:DR. MARY WALKER CLINIC
Practice Address - Street 2:BLDG 170
Practice Address - City:FORT IRWIN
Practice Address - State:CA
Practice Address - Zip Code:92310
Practice Address - Country:US
Practice Address - Phone:760-380-4766
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA652703163W00000X
PARN528111L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse