Provider Demographics
NPI:1952980864
Name:MERENDINO, MEAGAN R (RN)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:R
Last Name:MERENDINO
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 1:2745 RELDA CIR SW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44647-7395
Mailing Address - Country:US
Mailing Address - Phone:330-248-1331
Mailing Address - Fax:
Practice Address - Street 1:340 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:44615-1348
Practice Address - Country:US
Practice Address - Phone:330-627-5229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH452687163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine