Provider Demographics
NPI:1225534670
Name:ALLIGOOD, MEGAN WALKER (NP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:WALKER
Last Name:ALLIGOOD
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11201 N TATUM BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-6039
Mailing Address - Country:US
Mailing Address - Phone:510-529-7768
Mailing Address - Fax:
Practice Address - Street 1:11201 N TATUM BLVD STE 300
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-6039
Practice Address - Country:US
Practice Address - Phone:510-529-7768
Practice Address - Fax:302-400-8118
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ316857363L00000X
GARN202902363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner