Provider Demographics
NPI:1477377828
Name:OBERMEIER, MEGAN (FNP-BC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:OBERMEIER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2164 PRAIRIE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-2787
Mailing Address - Country:US
Mailing Address - Phone:712-363-4137
Mailing Address - Fax:
Practice Address - Street 1:2164 PRAIRIE VIEW DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-2787
Practice Address - Country:US
Practice Address - Phone:712-363-4137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14153131-8900363LF0000X
IAA181342363LF0000X
UT14153131-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily