Provider Demographics
NPI:1912232067
Name:MEGINNIS, LAURIE F
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:F
Last Name:MEGINNIS
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 1:8125 CELESTE DR
Mailing Address - Street 2:5115
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34113-1634
Mailing Address - Country:US
Mailing Address - Phone:239-304-6438
Mailing Address - Fax:
Practice Address - Street 1:8125 CELESTE DR
Practice Address - Street 2:5115
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-1634
Practice Address - Country:US
Practice Address - Phone:239-304-6438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-07
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9254385367500000X
MDR188047367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD419046700Medicaid
MD172115ZAR5Medicare PIN