Provider Demographics
NPI:1295422590
Name:PAIGE, MEAGAN MARIE
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:MARIE
Last Name:PAIGE
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 1:3655 W ANTHEM WAY STE A109255
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-0495
Mailing Address - Country:US
Mailing Address - Phone:206-914-8018
Mailing Address - Fax:
Practice Address - Street 1:130 E CREOSOTE DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-7222
Practice Address - Country:US
Practice Address - Phone:206-914-8018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based