Provider Demographics
NPI:1699357178
Name:NEUBERGER, MEGAN (NP-C)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:NEUBERGER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 WHITEHEAD DR
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7440
Mailing Address - Country:US
Mailing Address - Phone:218-255-2715
Mailing Address - Fax:
Practice Address - Street 1:840 WHITEHEAD DR
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-7440
Practice Address - Country:US
Practice Address - Phone:218-255-2715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-24
Last Update Date:2021-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028701363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily