Provider Demographics
NPI:1063173383
Name:WACHTER, MEGHAN K (PMHNP)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:K
Last Name:WACHTER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:674 W LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4882
Mailing Address - Country:US
Mailing Address - Phone:803-773-5227
Mailing Address - Fax:803-757-4010
Practice Address - Street 1:696 BULTMAN DR.
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-2549
Practice Address - Country:US
Practice Address - Phone:803-848-0500
Practice Address - Fax:803-848-0700
Is Sole Proprietor?:No
Enumeration Date:2022-01-08
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25691363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health