Provider Demographics
NPI:1952680944
Name:MOFFATT, MEGAN (RN, BSN, MSN, CPNP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MOFFATT
Suffix:
Gender:F
Credentials:RN, BSN, MSN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 SMITH AVE N
Mailing Address - Street 2:CHILDREN'S HOSPITALS AND CLINICS OF MINNESOTA
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2387
Mailing Address - Country:US
Mailing Address - Phone:651-220-6705
Mailing Address - Fax:651-220-6589
Practice Address - Street 1:200 UNIVERSITY AVE E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2507
Practice Address - Country:US
Practice Address - Phone:651-726-2812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3792363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care