Provider Demographics
NPI:1972155844
Name:CRAVENS, MEGAN LYNNE
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:LYNNE
Last Name:CRAVENS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:LYNNE
Other - Last Name:BRASHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:510 S ROSENBERGER AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47712-4433
Mailing Address - Country:US
Mailing Address - Phone:812-480-3918
Mailing Address - Fax:
Practice Address - Street 1:1020 W VINE ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:IN
Practice Address - Zip Code:47670-1199
Practice Address - Country:US
Practice Address - Phone:812-385-5238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant