Provider Demographics
NPI:1912442534
Name:O'LOUGHLIN, MEGAN (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:O'LOUGHLIN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2613 TIMBERLEAF CIR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-2101
Mailing Address - Country:US
Mailing Address - Phone:612-867-4211
Mailing Address - Fax:
Practice Address - Street 1:3308 PRESTON RD
Practice Address - Street 2:STE 350-283
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7453
Practice Address - Country:US
Practice Address - Phone:612-867-4211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-05
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX805053390200000X
TXAP133243367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program