Provider Demographics
NPI:1972842698
Name:DOCKTER, MEGHAN ANN (CNM)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:ANN
Last Name:DOCKTER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:ANN
Other - Last Name:NEEDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2400 32ND AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-5800
Practice Address - Country:US
Practice Address - Phone:701-234-2000
Practice Address - Fax:701-234-8803
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR29990367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife