Provider Demographics
NPI:1679263255
Name:THOMPSON, MEAGAN
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:THOMPSON
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 1:765 MEADOW GLEN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45309-1168
Mailing Address - Country:US
Mailing Address - Phone:937-694-5539
Mailing Address - Fax:
Practice Address - Street 1:312 APPLE VALLEY DR
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:OH
Practice Address - Zip Code:45338-9305
Practice Address - Country:US
Practice Address - Phone:937-300-9876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide