Provider Demographics
NPI:1396903787
Name:DE KONING, MEGAN NICOLE (OTRL)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:NICOLE
Last Name:DE KONING
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61699 703RD RD
Mailing Address - Street 2:
Mailing Address - City:PAWNEE CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68420-2600
Mailing Address - Country:US
Mailing Address - Phone:515-554-0119
Mailing Address - Fax:
Practice Address - Street 1:11623 ARBOR ST STE 200
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2991
Practice Address - Country:US
Practice Address - Phone:402-334-6004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01569225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist