Provider Demographics
NPI:1194409532
Name:O'CONNELL, MEAGHAN K (PA-C)
Entity type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:K
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 REED ST
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH
Mailing Address - State:MA
Mailing Address - Zip Code:02769-1126
Mailing Address - Country:US
Mailing Address - Phone:508-243-0552
Mailing Address - Fax:
Practice Address - Street 1:15 REED ST
Practice Address - Street 2:
Practice Address - City:REHOBOTH
Practice Address - State:MA
Practice Address - Zip Code:02769-1126
Practice Address - Country:US
Practice Address - Phone:508-243-0552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant