Provider Demographics
NPI:1952934796
Name:KERRIGAN, MEGHAN (APN)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:KERRIGAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:
Other - Last Name:O'REILLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:723 S 16TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-2100
Mailing Address - Country:US
Mailing Address - Phone:215-801-1693
Mailing Address - Fax:
Practice Address - Street 1:318 WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1705
Practice Address - Country:US
Practice Address - Phone:856-547-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-20
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP021041363LF0000X
NJ26NJ01028100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily