Provider Demographics
NPI:1336335876
Name:SPEARS, MEGAN LYNN (ANP)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:LYNN
Last Name:SPEARS
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5113 S SAN JUAN PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-3726
Mailing Address - Country:US
Mailing Address - Phone:480-695-0387
Mailing Address - Fax:480-219-2975
Practice Address - Street 1:5113 S SAN JUAN PL
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-3726
Practice Address - Country:US
Practice Address - Phone:480-695-0387
Practice Address - Fax:480-219-2975
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTAP2819363LA2200X
AZAP2819363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000000OtherNO OTHER IDENTIFIERS AT THIS TIME
NAOtherNOT WITH INSURANCES