Provider Demographics
NPI:1881381267
Name:PURITZ, MEGAN R (APRN - NP)
Entity type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:R
Last Name:PURITZ
Suffix:
Gender:F
Credentials:APRN - NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1130 NW 22ND AVE STE 640
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-5488
Mailing Address - Country:US
Mailing Address - Phone:503-229-7976
Mailing Address - Fax:503-274-4867
Practice Address - Street 1:10201 SE MAIN ST STE 27
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2937
Practice Address - Country:US
Practice Address - Phone:503-256-0877
Practice Address - Fax:503-256-4188
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR10033590363L00000X
OHAPRN.CNP.0034428363LF0000X
OHRN.502936163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice