Provider Demographics
NPI:1396624169
Name:KIRSTEN, MEGHAN ELIZABETH (FNP-C)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ELIZABETH
Last Name:KIRSTEN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:ELIZABETH
Other - Last Name:KIRSTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:114 EMERSON ST
Mailing Address - Street 2:
Mailing Address - City:WALDRON
Mailing Address - State:MI
Mailing Address - Zip Code:49288-9700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:442 W HIGH ST
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:OH
Practice Address - Zip Code:43506-1681
Practice Address - Country:US
Practice Address - Phone:419-636-4517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704337978363LF0000X
OHA.P.R.N.CNP.0039980363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily