Provider Demographics
NPI:1700137346
Name:ORPHANOS, MEGAN LEE (CRNA)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:LEE
Last Name:ORPHANOS
Suffix:
Gender:F
Credentials:CRNA
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2720 RUMMELBROWN DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-4928
Mailing Address - Country:US
Mailing Address - Phone:304-549-6462
Mailing Address - Fax:
Practice Address - Street 1:3200 MACCORKLE AVE SE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1227
Practice Address - Country:US
Practice Address - Phone:304-388-5432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-23
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV088053367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered