Provider Demographics
NPI:1316491582
Name:ROSE, MEGAN
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:ROSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4342 LOCHURST DR
Mailing Address - Street 2:
Mailing Address - City:PFAFFTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27040-9819
Mailing Address - Country:US
Mailing Address - Phone:828-404-8888
Mailing Address - Fax:
Practice Address - Street 1:4342 LOCHURST DR
Practice Address - Street 2:
Practice Address - City:PFAFFTOWN
Practice Address - State:NC
Practice Address - Zip Code:27040-9819
Practice Address - Country:US
Practice Address - Phone:828-404-8888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-05
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9973225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics