Provider Demographics
NPI:1669843876
Name:RAY, MEGAN MARY (APNP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARY
Last Name:RAY
Suffix:
Gender:F
Credentials:APNP
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Mailing Address - Street 1:2555 N MARTIN LUTHER KING DR
Mailing Address - Street 2:MILWAUKEE HEALTH SERVICES,
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-2709
Mailing Address - Country:US
Mailing Address - Phone:414-372-8080
Mailing Address - Fax:414-562-8078
Practice Address - Street 1:2555 N MARTIN LUTHER KING DR
Practice Address - Street 2:MILWAUKEE HEALTH SERVICES, INC.
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-2709
Practice Address - Country:US
Practice Address - Phone:414-372-8080
Practice Address - Fax:414-562-8078
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI6480363L00000X, 363LP0808X
WI6480-33363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1669843876Medicaid