Provider Demographics
NPI:1609198951
Name:SOMERS, MEGAN (LPN)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:
Last Name:SOMERS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 RUGG AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-4609
Mailing Address - Country:US
Mailing Address - Phone:740-366-6571
Mailing Address - Fax:
Practice Address - Street 1:157 RUGG AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-4609
Practice Address - Country:US
Practice Address - Phone:740-366-6571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH111360164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse