Provider Demographics
NPI:1154141109
Name:FAWCETT, MEGHAN MARGARET (RN MSN AGAC-DNP)
Entity type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:MARGARET
Last Name:FAWCETT
Suffix:
Gender:F
Credentials:RN MSN AGAC-DNP
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Mailing Address - Street 1:641 E WATERFRONT DR APT 4107
Mailing Address - Street 2:
Mailing Address - City:MUNHALL
Mailing Address - State:PA
Mailing Address - Zip Code:15120-5050
Mailing Address - Country:US
Mailing Address - Phone:443-980-6746
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-726-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN10015748363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner