Provider Demographics
NPI:1831656511
Name:POMERLEAU, MEAGAN ANNE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:MEAGAN
Middle Name:ANNE
Last Name:POMERLEAU
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 NEWGATE ST NW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-2918
Mailing Address - Country:US
Mailing Address - Phone:321-261-5527
Mailing Address - Fax:
Practice Address - Street 1:490 NEWGATE ST NW
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-2918
Practice Address - Country:US
Practice Address - Phone:321-261-5527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9343953363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner