Provider Demographics
NPI:1306641568
Name:NOLAND, MEGAN GLYN (NP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:GLYN
Last Name:NOLAND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:GLYN
Other - Last Name:REEVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:717 N GALVESTON ST
Mailing Address - Street 2:
Mailing Address - City:THAYER
Mailing Address - State:KS
Mailing Address - Zip Code:66776-4033
Mailing Address - Country:US
Mailing Address - Phone:620-432-1769
Mailing Address - Fax:
Practice Address - Street 1:1527 MADISON ST
Practice Address - Street 2:
Practice Address - City:FREDONIA
Practice Address - State:KS
Practice Address - Zip Code:66736-1751
Practice Address - Country:US
Practice Address - Phone:620-378-2121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-84055-101363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily