Provider Demographics
NPI:1851575963
Name:REICH, MEGAN MELISSA (CRNA)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:MELISSA
Last Name:REICH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 633
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34681-0633
Mailing Address - Country:US
Mailing Address - Phone:917-848-7748
Mailing Address - Fax:
Practice Address - Street 1:953 POINT SEASIDE DR
Practice Address - Street 2:
Practice Address - City:CRYSTAL BEACH
Practice Address - State:FL
Practice Address - Zip Code:34681-0633
Practice Address - Country:US
Practice Address - Phone:917-848-7488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY555088367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered