Provider Demographics
NPI:1740828458
Name:CONSEDINE, MEAGHAN E (NP)
Entity type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:E
Last Name:CONSEDINE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 ELLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-1431
Mailing Address - Country:US
Mailing Address - Phone:413-636-6476
Mailing Address - Fax:
Practice Address - Street 1:9 NORTH RD UNIT 202
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-2755
Practice Address - Country:US
Practice Address - Phone:978-275-9440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2295269363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily