Provider Demographics
NPI:1134403884
Name:MERRIGAN, MEGAN RENEE (PNP)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:RENEE
Last Name:MERRIGAN
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
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Mailing Address - Street 1:1 MERCY WAY
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72714-3000
Mailing Address - Country:US
Mailing Address - Phone:479-802-5555
Mailing Address - Fax:479-876-2829
Practice Address - Street 1:2601 GENE GEORGE BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0845
Practice Address - Country:US
Practice Address - Phone:479-725-6880
Practice Address - Fax:479-725-6882
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARA003612363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR199117758Medicaid