Provider Demographics
NPI:1629750666
Name:HORAN, MEAGHAN (FAMILY NP)
Entity Type:Individual
Prefix:MRS
First Name:MEAGHAN
Middle Name:
Last Name:HORAN
Suffix:
Gender:F
Credentials:FAMILY NP
Other - Prefix:MS
Other - First Name:MEAGHAN
Other - Middle Name:
Other - Last Name:MISCHKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40 BUNNELL PL
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-6418
Mailing Address - Country:US
Mailing Address - Phone:516-784-0291
Mailing Address - Fax:
Practice Address - Street 1:2048 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706
Practice Address - Country:US
Practice Address - Phone:631-968-7466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY692891-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse