Provider Demographics
NPI:1134532229
Name:MALOUF, MEGAN (RN)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MALOUF
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 CHEROKEE ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74801-5561
Mailing Address - Country:US
Mailing Address - Phone:405-395-9303
Mailing Address - Fax:405-395-9305
Practice Address - Street 1:2307 GORDON COOPER DR.
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801
Practice Address - Country:US
Practice Address - Phone:405-395-9303
Practice Address - Fax:405-395-9305
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK109984163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health