Provider Demographics
NPI:1336888791
Name:PLATT, MEGAN JO (ARNP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:JO
Last Name:PLATT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:IA
Mailing Address - Zip Code:51566-1305
Mailing Address - Country:US
Mailing Address - Phone:712-623-7000
Mailing Address - Fax:
Practice Address - Street 1:908 MAIN ST
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:IA
Practice Address - Zip Code:51551-8147
Practice Address - Country:US
Practice Address - Phone:712-624-6010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-02
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE84709163W00000X
IAA169589363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty