Provider Demographics
NPI:1912030297
Name:MACY, MEGHAN E (FNP)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:E
Last Name:MACY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11900 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64145-1004
Mailing Address - Country:US
Mailing Address - Phone:816-942-6587
Mailing Address - Fax:
Practice Address - Street 1:9784 N ASH AVENUE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64157
Practice Address - Country:US
Practice Address - Phone:816-781-4244
Practice Address - Fax:816-781-3542
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002025419363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MON23F332Medicare PIN