Provider Demographics
NPI:1548921786
Name:PEARCE, MEGAN LINDSAY
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LINDSAY
Last Name:PEARCE
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 1:748 CRESTVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37772-5960
Mailing Address - Country:US
Mailing Address - Phone:540-735-7767
Mailing Address - Fax:
Practice Address - Street 1:748 CRESTVIEW CIR
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37772-5960
Practice Address - Country:US
Practice Address - Phone:540-735-7767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-09
Last Update Date:2022-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3137224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3137OtherSTATE OF TENNESSEE