Provider Demographics
NPI:1902323405
Name:POHLMAN, MEGAN SHARON (PA-C)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:SHARON
Last Name:POHLMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:SHARON
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1052 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:WINDOM
Mailing Address - State:MN
Mailing Address - Zip Code:56101-1337
Mailing Address - Country:US
Mailing Address - Phone:507-221-4046
Mailing Address - Fax:
Practice Address - Street 1:308 8TH ST N
Practice Address - Street 2:
Practice Address - City:MOUNTAIN LAKE
Practice Address - State:MN
Practice Address - Zip Code:56159-1568
Practice Address - Country:US
Practice Address - Phone:507-427-3332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant