Provider Demographics
NPI:1700604378
Name:FLECKENSTEIN, MEGHAN CLARE (CRNA)
Entity type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:CLARE
Last Name:FLECKENSTEIN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:CLARE
Other - Last Name:FALSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:204 RIVERFRONT PKWY
Mailing Address - Street 2:
Mailing Address - City:MT HOLLY
Mailing Address - State:NC
Mailing Address - Zip Code:28120-1590
Mailing Address - Country:US
Mailing Address - Phone:847-217-3210
Mailing Address - Fax:
Practice Address - Street 1:2525 COURT DR
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2140
Practice Address - Country:US
Practice Address - Phone:704-834-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-01
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7585367500000X
NC365014163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse