Provider Demographics
NPI:1598015091
Name:DOODY, MEGHAN MCGOWAN DWYER (CRNP)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:MCGOWAN DWYER
Last Name:DOODY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:MCGOWAN
Other - Last Name:DWYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8901 WISCONSIN AVE
Mailing Address - Street 2:BUILDING 17, 2ND FLOOR, SUITE 2A
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-0004
Mailing Address - Country:US
Mailing Address - Phone:301-400-1111
Mailing Address - Fax:
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:BUILDING 17, 2ND FLOOR, SUITE 2A
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0004
Practice Address - Country:US
Practice Address - Phone:301-400-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1016551363L00000X
MDR200417363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner