Provider Demographics
NPI:1316109416
Name:ART, MEAGAN LEIGH (FNP)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:LEIGH
Last Name:ART
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3141 N 3RD AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4360
Mailing Address - Country:US
Mailing Address - Phone:602-914-1520
Mailing Address - Fax:602-914-1521
Practice Address - Street 1:3141 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4360
Practice Address - Country:US
Practice Address - Phone:602-914-1520
Practice Address - Fax:602-914-1521
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP2957363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ246281Medicaid
AZ246281Medicaid