Provider Demographics
NPI:1003653858
Name:WARD, MEGAN (NP-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:VANDERKOOI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:82 COLLEGE LN
Mailing Address - Street 2:
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30533
Mailing Address - Country:US
Mailing Address - Phone:706-864-1400
Mailing Address - Fax:
Practice Address - Street 1:82 COLLEGE LN
Practice Address - Street 2:
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533
Practice Address - Country:US
Practice Address - Phone:706-864-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36519363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily