Provider Demographics
NPI:1861121329
Name:DESCHAINE, MEGAN L (PA-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:L
Last Name:DESCHAINE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 RIVERSIDE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-1383
Mailing Address - Country:US
Mailing Address - Phone:603-883-0091
Mailing Address - Fax:603-881-3739
Practice Address - Street 1:17 RIVERSIDE ST STE 101
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-1383
Practice Address - Country:US
Practice Address - Phone:603-883-0091
Practice Address - Fax:603-881-3739
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1906363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant