Provider Demographics
NPI:1306114467
Name:SCHAUB, MEGAN MAE (FNP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MAE
Last Name:SCHAUB
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:65 WALNUT STREET
Mailing Address - Street 2:SUITE 440
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-2118
Mailing Address - Country:US
Mailing Address - Phone:781-235-9089
Mailing Address - Fax:781-237-5121
Practice Address - Street 1:65 WALNUT STREET
Practice Address - Street 2:SUITE 440
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-2118
Practice Address - Country:US
Practice Address - Phone:781-235-9089
Practice Address - Fax:781-237-5121
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN263126363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB73293Medicare UPIN