Provider Demographics
NPI:1871828418
Name:PURCELL, MEGAN (MSN, FNP-C, RD, LD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:PURCELL
Suffix:
Gender:F
Credentials:MSN, FNP-C, RD, LD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ELIZABETH
Other - Last Name:BORIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:102 EASTLAND RD
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:OH
Mailing Address - Zip Code:44017-2035
Mailing Address - Country:US
Mailing Address - Phone:216-509-0200
Mailing Address - Fax:
Practice Address - Street 1:148 E 38TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2607
Practice Address - Country:US
Practice Address - Phone:844-359-8363
Practice Address - Fax:833-955-3562
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6242133V00000X
NY1043889967261QM2500X
CT1992372403261QM2500X
NJ1992372403261QM2500X
OHAPRN.CNP.020449363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty