Provider Demographics
NPI:1881227106
Name:SEALS, MEGAN (PMHNP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:SEALS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 E CANAL ST STE E
Mailing Address - Street 2:
Mailing Address - City:PICAYUNE
Mailing Address - State:MS
Mailing Address - Zip Code:39466-4537
Mailing Address - Country:US
Mailing Address - Phone:601-202-9644
Mailing Address - Fax:
Practice Address - Street 1:116 E CANAL ST STE E
Practice Address - Street 2:
Practice Address - City:PICAYUNE
Practice Address - State:MS
Practice Address - Zip Code:39466-4537
Practice Address - Country:US
Practice Address - Phone:601-202-9644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-14
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA211655363LP0808X
MS903887363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health