Provider Demographics
NPI:1609318922
Name:DOHENY, MEGAN (MSN, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:DOHENY
Suffix:
Gender:F
Credentials:MSN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 S LAKE PARK AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-6790
Mailing Address - Country:US
Mailing Address - Phone:219-942-8620
Mailing Address - Fax:
Practice Address - Street 1:1400 S LAKE PARK AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-6790
Practice Address - Country:US
Practice Address - Phone:219-942-8620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71006703A363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health