Provider Demographics
NPI:1255179438
Name:TARVIS, MEGHAN EVE (RN)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:EVE
Last Name:TARVIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446G NORWICH WESTERLY RD
Mailing Address - Street 2:
Mailing Address - City:NORTH STONINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06359-1515
Mailing Address - Country:US
Mailing Address - Phone:401-585-0122
Mailing Address - Fax:
Practice Address - Street 1:1548 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226-1142
Practice Address - Country:US
Practice Address - Phone:860-423-8426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2025-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT15648363LW0102X
RIRN68653163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse