Provider Demographics
NPI:1881107183
Name:HIRSTINE, MEGAN MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:HIRSTINE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:MARIE
Other - Last Name:SCARTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1059 BEAVER CREEK COMMONS DR UNIT 230
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-3918
Mailing Address - Country:US
Mailing Address - Phone:984-960-1300
Mailing Address - Fax:984-960-1310
Practice Address - Street 1:1059 BEAVER CREEK COMMONS DR UNIT 230
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-3918
Practice Address - Country:US
Practice Address - Phone:984-960-1300
Practice Address - Fax:984-960-1310
Is Sole Proprietor?:No
Enumeration Date:2017-11-08
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-09518363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1881107183Medicaid