Provider Demographics
NPI:1346064219
Name:FLAHERTY, MEAGAN MICHELLE (CPM, LM)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:MICHELLE
Last Name:FLAHERTY
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13175 TRACK LN
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23430-3803
Mailing Address - Country:US
Mailing Address - Phone:804-684-1748
Mailing Address - Fax:
Practice Address - Street 1:13175 TRACK LN
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:VA
Practice Address - Zip Code:23430-3803
Practice Address - Country:US
Practice Address - Phone:804-684-1748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0129000209176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife