Provider Demographics
NPI:1922431014
Name:SMITH, MEGAN TAYLOR (FNP-BC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:TAYLOR
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:TAYLOR
Other - Last Name:WIND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1501 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2553
Mailing Address - Country:US
Mailing Address - Phone:804-288-7246
Mailing Address - Fax:804-288-7245
Practice Address - Street 1:1501 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2553
Practice Address - Country:US
Practice Address - Phone:804-288-7246
Practice Address - Fax:804-288-7245
Is Sole Proprietor?:No
Enumeration Date:2013-08-13
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171090363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily