Provider Demographics
NPI:1629836457
Name:CHARLES, MEGHAN ELIZABETH
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ELIZABETH
Last Name:CHARLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 CLOVER HILL LN
Mailing Address - Street 2:
Mailing Address - City:SPRING CITY
Mailing Address - State:PA
Mailing Address - Zip Code:19475-2312
Mailing Address - Country:US
Mailing Address - Phone:570-460-6808
Mailing Address - Fax:
Practice Address - Street 1:3400 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4238
Practice Address - Country:US
Practice Address - Phone:215-662-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN699311163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn