Provider Demographics
NPI:1184607939
Name:PAGE, MEEGAN D (ARNP)
Entity type:Individual
Prefix:
First Name:MEEGAN
Middle Name:D
Last Name:PAGE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14548 CALUSA PALMS DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-7769
Mailing Address - Country:US
Mailing Address - Phone:941-313-9894
Mailing Address - Fax:941-866-8111
Practice Address - Street 1:14548 CALUSA PALMS DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-7769
Practice Address - Country:US
Practice Address - Phone:941-313-9894
Practice Address - Fax:941-866-8111
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1130652367A00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL304984100Medicaid
FL304984100Medicaid
FLU6782XMedicare PIN