Provider Demographics
NPI:1033920699
Name:ATHEY, MEAGAN JO
Entity type:Individual
Prefix:MS
First Name:MEAGAN
Middle Name:JO
Last Name:ATHEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 7TH ST APT C
Mailing Address - Street 2:
Mailing Address - City:GERING
Mailing Address - State:NE
Mailing Address - Zip Code:69341-3543
Mailing Address - Country:US
Mailing Address - Phone:308-225-3600
Mailing Address - Fax:
Practice Address - Street 1:817 7TH ST APT C
Practice Address - Street 2:
Practice Address - City:GERING
Practice Address - State:NE
Practice Address - Zip Code:69341-3543
Practice Address - Country:US
Practice Address - Phone:308-225-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE568946544OtherBCBS
NV5874OtherHEALTH PARTNERS
NE236Medicaid