Provider Demographics
NPI:1932918455
Name:GANZABA, MEGHAN ALLYN ASHLEY (FNP-C)
Entity type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:ALLYN ASHLEY
Last Name:GANZABA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:MEGHAN
Other - Middle Name:ALLYN ASHLEY
Other - Last Name:DEMPSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5651 WHITE DOVE LN
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:VA
Mailing Address - Zip Code:20124-0932
Mailing Address - Country:US
Mailing Address - Phone:703-231-1994
Mailing Address - Fax:
Practice Address - Street 1:5651 WHITE DOVE LN
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:VA
Practice Address - Zip Code:20124-0932
Practice Address - Country:US
Practice Address - Phone:703-231-1994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-31
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024193526363LF0000X
WV122666363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily