Provider Demographics
NPI:1720558554
Name:REICHERT, MEGAN MARIE (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:MARIE
Last Name:REICHERT
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:MARIE
Other - Last Name:LONGSHORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-CNP
Mailing Address - Street 1:3333 BURNET AVENUE
Mailing Address - Street 2:MLC 2023
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-6062
Mailing Address - Fax:513-636-7826
Practice Address - Street 1:3333 BURNET AVENUE
Practice Address - Street 2:MLC 2023
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4371
Practice Address - Fax:513-636-7657
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-05
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
OHAPRN.CNP.026496363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program