Provider Demographics
NPI:1184166720
Name:HERREN, MEGHAN (FNP)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:HERREN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2495
Mailing Address - Country:US
Mailing Address - Phone:931-528-9047
Mailing Address - Fax:931-372-0045
Practice Address - Street 1:100 W 3RD ST
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2495
Practice Address - Country:US
Practice Address - Phone:931-528-9047
Practice Address - Fax:931-372-0045
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22026363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN185872OtherSTATE OF TENNESSEE RN
TN22006OtherSTATE OF TENNESSEE APN