Provider Demographics
NPI:1548977523
Name:METTLER, MEGAN (CNM)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:METTLER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 WESTAGE BUSINESS CTR DR
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-2281
Mailing Address - Country:US
Mailing Address - Phone:845-231-5600
Mailing Address - Fax:845-231-5498
Practice Address - Street 1:2515 SOUTH RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-5473
Practice Address - Country:US
Practice Address - Phone:845-471-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN95322476163W00000X
GARN315148163W00000X
NY929007163W00000X
NY002289367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse