Provider Demographics
NPI:1386441335
Name:BALLOU, MEAGHAN
Entity type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:
Last Name:BALLOU
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 CRESCENT ST
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-1805
Mailing Address - Country:US
Mailing Address - Phone:978-427-8183
Mailing Address - Fax:
Practice Address - Street 1:19 CRESCENT ST
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1805
Practice Address - Country:US
Practice Address - Phone:978-427-8183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula