Provider Demographics
NPI:1952183287
Name:YANOSICK, MEAGAN BETH
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:BETH
Last Name:YANOSICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:BETH
Other - Last Name:EKAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 MELLON WAY
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-1197
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3186 S MARYLAND PKWY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2306
Practice Address - Country:US
Practice Address - Phone:702-961-8434
Practice Address - Fax:866-477-7631
Is Sole Proprietor?:No
Enumeration Date:2023-10-20
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV865055163WC0200X
PARN678050163WC0200X
NV147896367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine