Provider Demographics
NPI:1063292126
Name:MESSICK, MEGAN (RN)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MESSICK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:TEAGUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:171 E SILVER BUGLE DR
Mailing Address - Street 2:
Mailing Address - City:CAMP VERDE
Mailing Address - State:AZ
Mailing Address - Zip Code:86322-7323
Mailing Address - Country:US
Mailing Address - Phone:928-301-7188
Mailing Address - Fax:
Practice Address - Street 1:410 CAMP LINCOLN RD
Practice Address - Street 2:
Practice Address - City:CAMP VERDE
Practice Address - State:AZ
Practice Address - Zip Code:86322-7494
Practice Address - Country:US
Practice Address - Phone:928-567-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN201670163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool