Provider Demographics
NPI:1265248157
Name:ELROD, MEAGAN BRIANNA
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:BRIANNA
Last Name:ELROD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 RIDGE FIELD CT
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48371-3662
Mailing Address - Country:US
Mailing Address - Phone:512-213-8256
Mailing Address - Fax:
Practice Address - Street 1:35 RIDGE FIELD CT
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MI
Practice Address - Zip Code:48371-3662
Practice Address - Country:US
Practice Address - Phone:512-213-8256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704343465163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse