Provider Demographics
NPI:1184968653
Name:STANBURY, MEGAN BROOKE (RN, BSN, MS, CRNA)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:BROOKE
Last Name:STANBURY
Suffix:
Gender:F
Credentials:RN, BSN, MS, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5110 N 44TH ST
Mailing Address - Street 2:L200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-1649
Mailing Address - Country:US
Mailing Address - Phone:602-343-2900
Mailing Address - Fax:
Practice Address - Street 1:5110 N 44TH ST
Practice Address - Street 2:L200
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-1649
Practice Address - Country:US
Practice Address - Phone:602-343-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-21
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY600745163WC0200X
NY91999367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine