Provider Demographics
NPI:1831542646
Name:LAVIN, MEGHAN ELIZABETH (CNP)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ELIZABETH
Last Name:LAVIN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 BELMONT STREET
Mailing Address - Street 2:UMASS MEMORIAL MEDICAL CENTER, PRE-SURGICAL EVALUATION
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605
Mailing Address - Country:US
Mailing Address - Phone:508-334-8497
Mailing Address - Fax:508-334-5383
Practice Address - Street 1:119 BELMONT ST
Practice Address - Street 2:UMASS MEMORIAL MEDICAL CENTER, PRE-SURGICAL EVALUATION
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2903
Practice Address - Country:US
Practice Address - Phone:508-334-8497
Practice Address - Fax:508-334-5383
Is Sole Proprietor?:No
Enumeration Date:2016-07-16
Last Update Date:2016-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2266851363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner