Provider Demographics
NPI:1578805792
Name:SMITH, MEAGAN ELIZABETH (GC)
Entity Type:Individual
Prefix:MRS
First Name:MEAGAN
Middle Name:ELIZABETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:GC
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:ELIZABETH
Other - Last Name:ORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:GC
Mailing Address - Street 1:409 S 2ND ST STE 2F
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4300 LONDONDERRY RD STE 202
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5317
Practice Address - Country:US
Practice Address - Phone:717-545-5000
Practice Address - Fax:717-545-5002
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAGC000222170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS