Provider Demographics
NPI:1578857488
Name:GOLIGHTLY, MEGAN LYNN (CRNP)
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:LYNN
Last Name:GOLIGHTLY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:180 PATRICIA AVE
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-8103
Mailing Address - Country:US
Mailing Address - Phone:727-733-4193
Mailing Address - Fax:813-635-2638
Practice Address - Street 1:180 PATRICIA AVE
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-8103
Practice Address - Country:US
Practice Address - Phone:727-733-4193
Practice Address - Fax:813-635-2638
Is Sole Proprietor?:No
Enumeration Date:2011-06-08
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011426363LF0000X
FLAPRN11014726363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102885166Medicaid
PA228369Medicare PIN