Provider Demographics
NPI:1790077071
Name:GIERE, MEGAN LYNNETTE (PA-C)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:LYNNETTE
Last Name:GIERE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:LYNNETTE
Other - Last Name:LEACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:4909 WATERS EDGE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-2462
Mailing Address - Country:US
Mailing Address - Phone:919-589-1204
Mailing Address - Fax:919-589-1264
Practice Address - Street 1:4909 WATERS EDGE DR STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-2462
Practice Address - Country:US
Practice Address - Phone:919-589-1204
Practice Address - Fax:919-589-1264
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH003255363AM0700X
NC0010-08173363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical