Provider Demographics
NPI:1356445886
Name:EISEL, MEGAN MOSER (PA-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MOSER
Last Name:EISEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 UNIVERSITY AVE STE B
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-4790
Mailing Address - Country:US
Mailing Address - Phone:563-900-8922
Mailing Address - Fax:563-279-0653
Practice Address - Street 1:1550 UNIVERSITY AVE STE B
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-4790
Practice Address - Country:US
Practice Address - Phone:563-900-8922
Practice Address - Fax:563-279-0653
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002195363AM0700X, 363A00000X, 363AM0700X
IN99022483A363AM0700X
IL385001103363AM0700X
MIL716638363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN4995000NNNNMedicare PIN