Provider Demographics
NPI:1104448166
Name:PHARRIS, MEGAN CORIELL (AGACNP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:CORIELL
Last Name:PHARRIS
Suffix:
Gender:
Credentials:AGACNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3158 FREEDOM DR STE 3102
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-0014
Mailing Address - Country:US
Mailing Address - Phone:704-971-7099
Mailing Address - Fax:704-971-0035
Practice Address - Street 1:10710 SIKES PL STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-8194
Practice Address - Country:US
Practice Address - Phone:042-485-1017
Practice Address - Fax:704-248-5120
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
NC222281363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program