Provider Demographics
NPI:1184736712
Name:WELLARD, MEGHANN L (CRNP)
Entity type:Individual
Prefix:
First Name:MEGHANN
Middle Name:L
Last Name:WELLARD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 RITCHIE HWY STE 209
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-2741
Mailing Address - Country:US
Mailing Address - Phone:410-789-7337
Mailing Address - Fax:410-349-1107
Practice Address - Street 1:1460 RITCHIE HWY STE 209
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-2741
Practice Address - Country:US
Practice Address - Phone:410-789-7337
Practice Address - Fax:410-349-1107
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR157352363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD013786300Medicaid