Provider Demographics
NPI:1740903020
Name:BEATTIE-CASSAN, MEGAN RUTH (FNP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:RUTH
Last Name:BEATTIE-CASSAN
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:PO BOX 498
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05254-0498
Mailing Address - Country:US
Mailing Address - Phone:802-549-8238
Mailing Address - Fax:866-344-8830
Practice Address - Street 1:57 SEMINARY AVE
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05254-4189
Practice Address - Country:US
Practice Address - Phone:802-549-8238
Practice Address - Fax:866-344-8830
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0135612PROV207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine