Provider Demographics
NPI:1194236059
Name:JENNINGS, MEGAN ALICE
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:ALICE
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:ALICE
Other - Last Name:WEBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6971 CLOVER BLOSSOM LN NE
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98311-9527
Mailing Address - Country:US
Mailing Address - Phone:360-440-0383
Mailing Address - Fax:
Practice Address - Street 1:6971 CLOVER BLOSSOM LN NE
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98311-9527
Practice Address - Country:US
Practice Address - Phone:360-440-0383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula