Provider Demographics
NPI:1851537997
Name:STICHER, MEGAN ALYCIA (NPC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ALYCIA
Last Name:STICHER
Suffix:
Gender:F
Credentials:NPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:975 E 3RD ST
Mailing Address - Street 2:ATTN: PROVIDER ENROLLMENT
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2147
Mailing Address - Country:US
Mailing Address - Phone:423-267-4585
Mailing Address - Fax:423-756-1307
Practice Address - Street 1:979 E 3RD ST
Practice Address - Street 2:SUITE C-220
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2136
Practice Address - Country:US
Practice Address - Phone:423-267-4585
Practice Address - Fax:423-756-1307
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN13886363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily