Provider Demographics
NPI:1013526565
Name:ELLIOTT, MEGAN RENAE (APRN-NP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:RENAE
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:APRN-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1780 COUNTY ROAD M
Mailing Address - Street 2:
Mailing Address - City:WAHOO
Mailing Address - State:NE
Mailing Address - Zip Code:68066-5503
Mailing Address - Country:US
Mailing Address - Phone:402-277-0950
Mailing Address - Fax:
Practice Address - Street 1:14100 CRAWFORD ST
Practice Address - Street 2:
Practice Address - City:BOYS TOWN
Practice Address - State:NE
Practice Address - Zip Code:68010-7520
Practice Address - Country:US
Practice Address - Phone:531-355-1758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE63632163WP0200X
NE113303363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WP0200XNursing Service ProvidersRegistered NursePediatrics