Provider Demographics
NPI:1780557793
Name:LAMBOURNE, MEGHAN ELIZABETH (BS, MS, ACSM)
Entity type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:ELIZABETH
Last Name:LAMBOURNE
Suffix:
Gender:F
Credentials:BS, MS, ACSM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 DONNA LN
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-8153
Mailing Address - Country:US
Mailing Address - Phone:231-510-0325
Mailing Address - Fax:
Practice Address - Street 1:3650 DONNA LN
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-8153
Practice Address - Country:US
Practice Address - Phone:231-510-0325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1002134224Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise PhysiologistGroup - Single Specialty