Provider Demographics
NPI:1639862360
Name:ZILLA, MEGAN RAE (CNM, APRN, BSN, RN)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:RAE
Last Name:ZILLA
Suffix:
Gender:F
Credentials:CNM, APRN, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3726 E CAROB DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-0427
Mailing Address - Country:US
Mailing Address - Phone:602-821-9118
Mailing Address - Fax:
Practice Address - Street 1:3726 E CAROB DR
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85298-0427
Practice Address - Country:US
Practice Address - Phone:602-821-9118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ291223176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife