Provider Demographics
NPI:1265697023
Name:MESAROS, MEGAN BETH (CNM)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:BETH
Last Name:MESAROS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:63 PITT ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-2102
Mailing Address - Country:US
Mailing Address - Phone:724-804-5195
Mailing Address - Fax:724-804-5980
Practice Address - Street 1:620 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4804
Practice Address - Country:US
Practice Address - Phone:814-942-5000
Practice Address - Fax:814-942-9500
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMW010182367A00000X
PASP028342363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA132225Medicare PIN