Provider Demographics
NPI:1659905834
Name:BROWN, MEAGAN MCINVILLE (RN BSN)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:MCINVILLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WARRIOR WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-9241
Mailing Address - Country:US
Mailing Address - Phone:843-849-2830
Mailing Address - Fax:843-849-2880
Practice Address - Street 1:1000 WARRIOR WAY
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-9241
Practice Address - Country:US
Practice Address - Phone:843-849-2830
Practice Address - Fax:843-849-2880
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC205637163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC205637Medicaid