Provider Demographics
NPI:1912724261
Name:ELLIOTT, MEAGAN (RN)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:ELLIOTT
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 1:21001 RACHEL MYERS LN
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-4627
Mailing Address - Country:US
Mailing Address - Phone:770-530-8876
Mailing Address - Fax:
Practice Address - Street 1:22660 CANAL RD
Practice Address - Street 2:
Practice Address - City:ORANGE BEACH
Practice Address - State:AL
Practice Address - Zip Code:36561-3801
Practice Address - Country:US
Practice Address - Phone:251-986-2696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-149508163W00000X, 163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No163W00000XNursing Service ProvidersRegistered Nurse