Provider Demographics
NPI:1104508043
Name:MCGUINESS, MEGAN (MSN, APRN, PMNHP-BC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MCGUINESS
Suffix:
Gender:F
Credentials:MSN, APRN, PMNHP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2152 37TH ST APT B
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544-2483
Mailing Address - Country:US
Mailing Address - Phone:505-350-2654
Mailing Address - Fax:
Practice Address - Street 1:2152 37TH ST APT B
Practice Address - Street 2:
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544-2483
Practice Address - Country:US
Practice Address - Phone:505-350-2654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM75015363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health