Provider Demographics
NPI:1841597820
Name:NEXUS HEALTHCARE PA
Entity type:Organization
Organization Name:NEXUS HEALTHCARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEEGAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:941-313-9894
Mailing Address - Street 1:14548 CALUSA PALMS DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-7769
Mailing Address - Country:US
Mailing Address - Phone:941-313-9794
Mailing Address - Fax:239-839-3319
Practice Address - Street 1:14548 CALUSA PALMS DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-7769
Practice Address - Country:US
Practice Address - Phone:941-313-9794
Practice Address - Fax:239-839-3319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-28
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1130652367A00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLES198BMedicare PIN
FLES198AMedicare PIN