Provider Demographics
NPI:1912355645
Name:ABEL, MEAGAN STARK (CRNA)
Entity type:Individual
Prefix:MRS
First Name:MEAGAN
Middle Name:STARK
Last Name:ABEL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:ASHLEY
Other - Last Name:STARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20006 MARKWARD XING
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-7628
Mailing Address - Country:US
Mailing Address - Phone:561-706-7311
Mailing Address - Fax:
Practice Address - Street 1:20006 MARKWARD XING
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-7628
Practice Address - Country:US
Practice Address - Phone:561-706-7311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-03
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9293695163W00000X
FLARNP9293695367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse