Provider Demographics
NPI:1366208795
Name:KAHABKA, MEGHANN MARIE
Entity type:Individual
Prefix:MRS
First Name:MEGHANN
Middle Name:MARIE
Last Name:KAHABKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FLOOD
Other - Middle Name:MARIE
Other - Last Name:FLOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:7727 W DEER VALLEY RD STE 215
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-2121
Mailing Address - Country:US
Mailing Address - Phone:623-404-2244
Mailing Address - Fax:
Practice Address - Street 1:7727 W DEER VALLEY RD STE 215
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-2121
Practice Address - Country:US
Practice Address - Phone:623-404-2244
Practice Address - Fax:623-404-2245
Is Sole Proprietor?:No
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ302873363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily