Provider Demographics
NPI:1427802024
Name:TARHANICH, MEGAN (CPNP)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:TARHANICH
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9616 COLUMBIA
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-2306
Mailing Address - Country:US
Mailing Address - Phone:734-679-7463
Mailing Address - Fax:
Practice Address - Street 1:28300 ORCHARD LAKE RD STE 100A
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3704
Practice Address - Country:US
Practice Address - Phone:248-855-7510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH518427163W00000X
MI4704408348163W00000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse