Provider Demographics
| NPI: | 1538853130 |
|---|---|
| Name: | MEGAN MCKEON |
| Entity type: | Organization |
| Organization Name: | MEGAN MCKEON |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | NURSE PRACTITIONER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | MEGAN |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | MCKEON |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | FNP-C |
| Authorized Official - Phone: | 844-776-7200 |
| Mailing Address - Street 1: | 14021 NEW HALLS FERRY RD STE A |
| Mailing Address - Street 2: | |
| Mailing Address - City: | FLORISSANT |
| Mailing Address - State: | MO |
| Mailing Address - Zip Code: | 63033-2764 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 844-776-7200 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 14021 NEW HALLS FERRY RD STE A |
| Practice Address - Street 2: | |
| Practice Address - City: | FLORISSANT |
| Practice Address - State: | MO |
| Practice Address - Zip Code: | 63033-2764 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 844-776-7200 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | Yes |
| Parent Organization LBN: | SSM HEALTHCARE CORPORATION |
| Parent Organization TIN: | <UNAVAIL> |
| Enumeration Date: | 2023-06-06 |
| Last Update Date: | 2023-06-08 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Single Specialty |