Provider Demographics
NPI:1124258983
Name:WALTON, MEAGAN M (ARNP)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:M
Last Name:WALTON
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 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-7400
Mailing Address - Fax:239-468-7942
Practice Address - Street 1:8925 COLONIAL CENTER DR STE 1000
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-7813
Practice Address - Country:US
Practice Address - Phone:239-343-7400
Practice Address - Fax:239-468-7942
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN322699363LA2100X
OHNP10756363LA2100X
FLARNP9403153363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016140800Medicaid
OH2968801Medicaid
FL2410019OtherCIGNA
FLY0S20OtherBCBS
FL1233502OtherWELLCARE
FLP969339OtherOPTIMUM
FL398586OtherAVMED
FL9498535OtherAETNA
FLP995678OtherFREEDOM
FLP01591795OtherRR MEDICARE
FL1233502OtherWELLCARE
OH2968801Medicaid