Provider Demographics
NPI:1598206096
Name:JOHN, MEGAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:JOHN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 NEW SCOTLAND AVE
Mailing Address - Street 2:NEW SCOTLAND ELEM SCHOOL
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-2736
Mailing Address - Country:US
Mailing Address - Phone:518-475-6780
Mailing Address - Fax:518-475-6781
Practice Address - Street 1:369 NEW SCOTLAND AVE
Practice Address - Street 2:NEW SCOTLAND ELEM SCHOOL
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-2736
Practice Address - Country:US
Practice Address - Phone:518-475-6780
Practice Address - Fax:518-475-6781
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY466859-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse