Provider Demographics
NPI:1114750502
Name:CHROBAK, MEAGAN L (RN, CLC)
Entity type:Individual
Prefix:MRS
First Name:MEAGAN
Middle Name:L
Last Name:CHROBAK
Suffix:
Gender:F
Credentials:RN, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 NOTTINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1101
Mailing Address - Country:US
Mailing Address - Phone:508-317-4393
Mailing Address - Fax:
Practice Address - Street 1:25 NOTTINGHAM RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-1101
Practice Address - Country:US
Practice Address - Phone:508-317-4393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2301211163WL0100X
NH079928-21163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant