Provider Demographics
NPI:1609540509
Name:CLAVER, MEGHAN MARIE (NP-C)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:MARIE
Last Name:CLAVER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 MAIN ST APT 211
Mailing Address - Street 2:
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-1070
Mailing Address - Country:US
Mailing Address - Phone:315-935-3062
Mailing Address - Fax:
Practice Address - Street 1:90 PRESIDENTIAL PLZ FL 4
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-2240
Practice Address - Country:US
Practice Address - Phone:315-464-4243
Practice Address - Fax:315-464-7328
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY752986163W00000X
NYF07210050363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse