Provider Demographics
NPI:1285726919
Name:CALDWELL, MEAGAN ANN (ARNP)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:ANN
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 NAT WASHINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:WA
Mailing Address - Zip Code:98823-1982
Mailing Address - Country:US
Mailing Address - Phone:509-754-3330
Mailing Address - Fax:
Practice Address - Street 1:200 NAT WASHINGTON WAY
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:WA
Practice Address - Zip Code:98823-1982
Practice Address - Country:US
Practice Address - Phone:509-754-3330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007453363L00000X
WARN00157092163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0294907OtherL&I
WA8947727OtherSTATE CRIME VICTIM
WA0213726OtherSTATE L&I
WA0278790OtherSTATE L&I
WA8943196OtherSTATE CRIME VICTIMS
WAP01406893OtherRR MEDICARE
WA0237126OtherSTATE L&I
WA0274087OtherL&I
WA0278789OtherSTATE L&I
WA0301180OtherSTATE L&I
WA1285726919Medicaid
WA0278789OtherSTATE L&I
WAG8865274Medicare PIN
WA0237126OtherSTATE L&I
Q78958Medicare UPIN
WA0213726OtherSTATE L&I
WA0301180OtherSTATE L&I
WA0278790OtherSTATE L&I
WAG8874027Medicare PIN