Provider Demographics
NPI:1275141491
Name:ROPER, MEGAN COLE (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:COLE
Last Name:ROPER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 SAVOY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1071
Mailing Address - Country:US
Mailing Address - Phone:706-258-4140
Mailing Address - Fax:706-258-4141
Practice Address - Street 1:101 RIVERSTONE VIS STE 102
Practice Address - Street 2:
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-6630
Practice Address - Country:US
Practice Address - Phone:706-258-4140
Practice Address - Fax:706-258-4141
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA257926363LF0000X
GARN257926363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003242021BMedicaid
GAG23054AOtherMEDICARE PTAN
GA003242021AMedicaid