Provider Demographics
NPI:1952131955
Name:RUEDA, MEAGAN LEIGH (RN)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:LEIGH
Last Name:RUEDA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 BROADWAY APT B
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-1853
Mailing Address - Country:US
Mailing Address - Phone:201-679-5848
Mailing Address - Fax:
Practice Address - Street 1:119 BROADWAY APT B
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-1853
Practice Address - Country:US
Practice Address - Phone:201-679-5848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY639364-1163W00000X
NJ26NR14997200163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse