Provider Demographics
NPI:1831930296
Name:COLQUHOUN, MEAGAN ALTHEA
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:ALTHEA
Last Name:COLQUHOUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3395 EUCLID HEIGHTS BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1850
Mailing Address - Country:US
Mailing Address - Phone:216-278-8758
Mailing Address - Fax:
Practice Address - Street 1:3395 EUCLID HEIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1850
Practice Address - Country:US
Practice Address - Phone:216-278-8758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-01
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH486202163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice