Provider Demographics
NPI:1922436690
Name:NIX, MEAGHAN (RT(MR))
Entity Type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:
Last Name:NIX
Suffix:
Gender:F
Credentials:RT(MR)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 W MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:AR
Mailing Address - Zip Code:72150-7614
Mailing Address - Country:US
Mailing Address - Phone:501-680-5752
Mailing Address - Fax:
Practice Address - Street 1:2585 DONAGHEY AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-2327
Practice Address - Country:US
Practice Address - Phone:501-764-1201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR5177732471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging