Provider Demographics
NPI:1386429934
Name:GRUWELL, MEAGAN MAUREEN (APRN)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:MAUREEN
Last Name:GRUWELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:MAUREEN
Other - Last Name:COTTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7344 E DEER VALLEY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-7456
Mailing Address - Country:US
Mailing Address - Phone:480-513-1042
Mailing Address - Fax:
Practice Address - Street 1:7344 E DEER VALLEY RD STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7456
Practice Address - Country:US
Practice Address - Phone:480-513-1042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ296361363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner