Provider Demographics
NPI:1487242566
Name:WHITE, MEGAN ANNE (RN)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANNE
Last Name:WHITE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 ROYALLRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-6854
Mailing Address - Country:US
Mailing Address - Phone:314-971-1708
Mailing Address - Fax:
Practice Address - Street 1:12 ROYALLRIDGE CT
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-6854
Practice Address - Country:US
Practice Address - Phone:314-971-1708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009032547163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse