Provider Demographics
NPI:1033439542
Name:MCDURFEE, MEAGAN LEE (FNP-BC)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:LEE
Last Name:MCDURFEE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:LEE
Other - Last Name:BODELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:10 W. MARKET ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204
Mailing Address - Country:US
Mailing Address - Phone:866-434-3255
Mailing Address - Fax:
Practice Address - Street 1:2355 ENDRESS PL SUITE A
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143
Practice Address - Country:US
Practice Address - Phone:317-530-1811
Practice Address - Fax:317-963-1621
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28162119A363LF0000X
IN71003186A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201307000Medicaid
IN264430D70OtherMEDICARE PTAN