Provider Demographics
NPI:1649766106
Name:RUSZCZYK, MEGAN SONGER (CRNA)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:SONGER
Last Name:RUSZCZYK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8340 WILD DUNE LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-6007
Mailing Address - Country:US
Mailing Address - Phone:205-789-5982
Mailing Address - Fax:
Practice Address - Street 1:1068 CRESTHAVEN RD STE 150
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3859
Practice Address - Country:US
Practice Address - Phone:205-789-5982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000216874163W00000X
TNAPN0000024806207L00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology