Provider Demographics
NPI:1417613084
Name:ANDERSON, MEGGIE M (APRN)
Entity type:Individual
Prefix:
First Name:MEGGIE
Middle Name:M
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 229
Mailing Address - Street 2:
Mailing Address - City:NELIGH
Mailing Address - State:NE
Mailing Address - Zip Code:68756-0229
Mailing Address - Country:US
Mailing Address - Phone:402-887-4151
Mailing Address - Fax:402-887-4092
Practice Address - Street 1:102 W 9TH ST
Practice Address - Street 2:
Practice Address - City:NELIGH
Practice Address - State:NE
Practice Address - Zip Code:68756-1114
Practice Address - Country:US
Practice Address - Phone:402-887-4151
Practice Address - Fax:402-887-4092
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE113910363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner