Provider Demographics
NPI:1922471077
Name:BURR, MEGAN (LPN)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:BURR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2194 WISCONSIN ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-1027
Mailing Address - Country:US
Mailing Address - Phone:541-852-1398
Mailing Address - Fax:
Practice Address - Street 1:33142 CAMAS SWALE RD
Practice Address - Street 2:
Practice Address - City:CRESWELL
Practice Address - State:OR
Practice Address - Zip Code:97426-9732
Practice Address - Country:US
Practice Address - Phone:541-852-1398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201508601164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse