Provider Demographics
NPI:1700488467
Name:WHITE, MEAGHAN (RN)
Entity Type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 FANCHER RD
Mailing Address - Street 2:
Mailing Address - City:HOLLEY
Mailing Address - State:NY
Mailing Address - Zip Code:14470-9370
Mailing Address - Country:US
Mailing Address - Phone:585-794-1298
Mailing Address - Fax:
Practice Address - Street 1:3800 N MAIN STREET RD
Practice Address - Street 2:
Practice Address - City:HOLLEY
Practice Address - State:NY
Practice Address - Zip Code:14470-9381
Practice Address - Country:US
Practice Address - Phone:585-638-6318
Practice Address - Fax:585-638-5016
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY744906-01163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool