Provider Demographics
NPI:1780371948
Name:LOR, MEGAN KAJ-SIAB (RN)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:KAJ-SIAB
Last Name:LOR
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 1:7851 FIRWOOD WAY NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-2415
Mailing Address - Country:US
Mailing Address - Phone:763-370-9071
Mailing Address - Fax:
Practice Address - Street 1:555 CEDAR ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2209
Practice Address - Country:US
Practice Address - Phone:651-266-1255
Practice Address - Fax:651-266-1324
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2467256163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse