Provider Demographics
NPI:1063249423
Name:BUDGE, MEGAN LEE
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LEE
Last Name:BUDGE
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 1:1605 W HOMECOMING WAY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-1438
Mailing Address - Country:US
Mailing Address - Phone:831-236-8990
Mailing Address - Fax:
Practice Address - Street 1:1605 W HOMECOMING WAY
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-1438
Practice Address - Country:US
Practice Address - Phone:831-236-8990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program