Provider Demographics
NPI:1952703613
Name:HUMPHREYS, MEGAN (MSN, CPNP)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:HUMPHREYS
Suffix:
Gender:F
Credentials:MSN, CPNP
Other - Prefix:MISS
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:WHEATLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5875 BREMO RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1934
Mailing Address - Country:US
Mailing Address - Phone:804-281-8303
Mailing Address - Fax:804-212-1740
Practice Address - Street 1:5875 BREMO RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1934
Practice Address - Country:US
Practice Address - Phone:804-281-8303
Practice Address - Fax:804-212-1740
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN196602163W00000X
SC19092363LP0200X
VA0024175801363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse