Provider Demographics
NPI:1710062161
Name:BRIDE, MEGHAN K (MS, RNC)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:K
Last Name:BRIDE
Suffix:
Gender:F
Credentials:MS, RNC
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:
Other - Last Name:KANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20 WALL ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-4758
Mailing Address - Country:US
Mailing Address - Phone:781-221-2940
Mailing Address - Fax:781-221-2854
Practice Address - Street 1:20 WALL ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-4758
Practice Address - Country:US
Practice Address - Phone:781-221-2940
Practice Address - Fax:781-221-2854
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF420813363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health