Provider Demographics
NPI:1386891521
Name:EARHART, MEGAN M (MSN, ACNP)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:M
Last Name:EARHART
Suffix:
Gender:F
Credentials:MSN, ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4777 E GALBRAITH RD
Mailing Address - Street 2:5TH FLOOR BMTC
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2725
Mailing Address - Country:US
Mailing Address - Phone:513-686-5528
Mailing Address - Fax:513-686-3113
Practice Address - Street 1:4777 E GALBRAITH RD
Practice Address - Street 2:5TH FLOOR BMTC
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2725
Practice Address - Country:US
Practice Address - Phone:513-686-5528
Practice Address - Fax:513-686-3113
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP 10080363LA2100X
NC237686363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC232009OtherMEDICARE PTAN, GROUP
NC2594944OtherMEDICARE PTAN, INDIVIDUAL