Provider Demographics
NPI:1336754167
Name:BROWN, MEGAN (NP-C)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:DELONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:232 N MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:HERSCHER
Mailing Address - State:IL
Mailing Address - Zip Code:60941-9570
Mailing Address - Country:US
Mailing Address - Phone:309-846-7000
Mailing Address - Fax:
Practice Address - Street 1:692 N MAPLE ST
Practice Address - Street 2:
Practice Address - City:HERSCHER
Practice Address - State:IL
Practice Address - Zip Code:60941-9785
Practice Address - Country:US
Practice Address - Phone:815-426-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209021508363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily