Provider Demographics
NPI:1720182900
Name:GARRIGAN, MEGAN (PA/C)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:GARRIGAN
Suffix:
Gender:F
Credentials:PA/C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E STREET
Mailing Address - Street 2:
Mailing Address - City:ORLEANS
Mailing Address - State:VT
Mailing Address - Zip Code:05860
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30 EAST ST
Practice Address - Street 2:ORLEANS MEDICAL CLINIC
Practice Address - City:ORLEANS
Practice Address - State:VT
Practice Address - Zip Code:05860
Practice Address - Country:US
Practice Address - Phone:802-754-2220
Practice Address - Fax:802-754-2195
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT055-003227363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT2000905Medicaid
VTGARR19143OtherVT BCBS