Provider Demographics
NPI:1245825553
Name:MASON, MEGAN G (APRN)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:G
Last Name:MASON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:E
Other - Last Name:GABLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4371 VERONICA S SHOEMAKER BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-2216
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:239-278-3350
Practice Address - Street 1:3730 7TH TER STE 101
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6556
Practice Address - Country:US
Practice Address - Phone:772-567-2332
Practice Address - Fax:844-812-2806
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11009523363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily