Provider Demographics
NPI:1013424738
Name:CHARPIE, MEAGAN A (PA-C, ATC)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:A
Last Name:CHARPIE
Suffix:
Gender:F
Credentials:PA-C, ATC
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:A
Other - Last Name:FAULK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:1797 HADDEN HALL PL
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-7271
Mailing Address - Country:US
Mailing Address - Phone:904-403-9582
Mailing Address - Fax:
Practice Address - Street 1:36413 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-1329
Practice Address - Country:US
Practice Address - Phone:813-978-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-03
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL42482255A2300X
FLPA9114025363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer