Provider Demographics
NPI:1063740553
Name:OCONNER, MEGAN KATHLEEN (ARNP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:KATHLEEN
Last Name:OCONNER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-237-3985
Mailing Address - Fax:515-237-3994
Practice Address - Street 1:1540 HIGH STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-3108
Practice Address - Country:US
Practice Address - Phone:515-237-3985
Practice Address - Fax:515-237-3994
Is Sole Proprietor?:No
Enumeration Date:2009-11-23
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-106788363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner