Provider Demographics
NPI:1669179628
Name:SMITH, MEGHAN ANN (FNP)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 CREEKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-6205
Mailing Address - Country:US
Mailing Address - Phone:512-966-8057
Mailing Address - Fax:
Practice Address - Street 1:2410 ROUND ROCK AVE STE 150
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4019
Practice Address - Country:US
Practice Address - Phone:512-341-8724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1110560363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily