Provider Demographics
NPI:1689169773
Name:ALVARADO, MEAGEN REASON (FNP-C)
Entity Type:Individual
Prefix:
First Name:MEAGEN
Middle Name:REASON
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MEAGEN
Other - Middle Name:RENE
Other - Last Name:REASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1088A BAXTER ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-6316
Mailing Address - Country:US
Mailing Address - Phone:800-929-9502
Mailing Address - Fax:
Practice Address - Street 1:1088A BAXTER ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-6316
Practice Address - Country:US
Practice Address - Phone:800-929-9502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN231680363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily