Provider Demographics
NPI:1104445634
Name:OSWALD, MEGAN GRAMMATER (DNP, CRNA)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:GRAMMATER
Last Name:OSWALD
Suffix:
Gender:F
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7248 MIMOSA DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-5752
Mailing Address - Country:US
Mailing Address - Phone:208-413-3767
Mailing Address - Fax:
Practice Address - Street 1:7248 MIMOSA DR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-5752
Practice Address - Country:US
Practice Address - Phone:208-413-3767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-14
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN223051163W00000X
TN27731367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse