Provider Demographics
NPI:1881783660
Name:GRUGAN, MEGAN O'CONNOR (CRNP)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:O'CONNOR
Last Name:GRUGAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 DAVID RD
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-2314
Mailing Address - Country:US
Mailing Address - Phone:610-668-2536
Mailing Address - Fax:
Practice Address - Street 1:2701 BLAIR MILL RD
Practice Address - Street 2:SUITE 10
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1041
Practice Address - Country:US
Practice Address - Phone:215-675-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP004345B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily