Provider Demographics
NPI:1912424649
Name:BLATTEL, MEGAN J (FNP-BC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:J
Last Name:BLATTEL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:J
Other - Last Name:COLLIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:3 DOCTORS PARK
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-4927
Mailing Address - Country:US
Mailing Address - Phone:573-334-7748
Mailing Address - Fax:
Practice Address - Street 1:3 DOCTORS PARK
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-4927
Practice Address - Country:US
Practice Address - Phone:573-334-7748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017028432363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily