Provider Demographics
NPI:1962739151
Name:TITCOMB, MEGAN (CD, CH)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:TITCOMB
Suffix:
Gender:F
Credentials:CD, CH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2987 FRANK ST
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-1092
Mailing Address - Country:US
Mailing Address - Phone:651-398-0817
Mailing Address - Fax:
Practice Address - Street 1:4120 LEXINGTON WAY
Practice Address - Street 2:SUITE 150
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55123-1512
Practice Address - Country:US
Practice Address - Phone:651-398-0817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-09
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No175F00000XOther Service ProvidersNaturopath