Provider Demographics
NPI:1912490244
Name:WESTOVER, MEGHAN LEE
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:LEE
Last Name:WESTOVER
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 1:4000 MIAMISBURG CENTERVILLE RD STE 450
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-3908
Mailing Address - Country:US
Mailing Address - Phone:937-439-3600
Mailing Address - Fax:937-439-3786
Practice Address - Street 1:4000 MIAMISBURG CENTERVILLE RD STE 450
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342
Practice Address - Country:US
Practice Address - Phone:937-439-3600
Practice Address - Fax:937-439-3786
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.324527163W00000X
OHAPRN.CNP.023195363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH645570OtherMEDICARE PTAN
OHP02074395OtherRRMEDICARE PTAN
OH0305055Medicaid