Provider Demographics
NPI: | 1538853130 |
---|---|
Name: | MEGAN MCKEON |
Entity type: | Organization |
Organization Name: | MEGAN MCKEON |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | NURSE PRACTITIONER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MEGAN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MCKEON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | FNP-C |
Authorized Official - Phone: | 844-776-7200 |
Mailing Address - Street 1: | 14021 NEW HALLS FERRY RD STE A |
Mailing Address - Street 2: | |
Mailing Address - City: | FLORISSANT |
Mailing Address - State: | MO |
Mailing Address - Zip Code: | 63033-2764 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 844-776-7200 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 14021 NEW HALLS FERRY RD STE A |
Practice Address - Street 2: | |
Practice Address - City: | FLORISSANT |
Practice Address - State: | MO |
Practice Address - Zip Code: | 63033-2764 |
Practice Address - Country: | US |
Practice Address - Phone: | 844-776-7200 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | SSM HEALTHCARE CORPORATION |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2023-06-06 |
Last Update Date: | 2023-06-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Single Specialty |