Provider Demographics
NPI:1154109155
Name:BOETTCHER, MEGGAN LYNN (MSN, APRN, CNM)
Entity type:Individual
Prefix:
First Name:MEGGAN
Middle Name:LYNN
Last Name:BOETTCHER
Suffix:
Gender:
Credentials:MSN, APRN, CNM
Other - Prefix:
Other - First Name:MEGGAN
Other - Middle Name:
Other - Last Name:SCANLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:505 S MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MN
Mailing Address - Zip Code:55921-1334
Mailing Address - Country:US
Mailing Address - Phone:608-397-1885
Mailing Address - Fax:
Practice Address - Street 1:1836 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-5429
Practice Address - Country:US
Practice Address - Phone:608-782-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife