Provider Demographics
NPI:1972155232
Name:STUTHEIT, MEGAN L (FNP-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:L
Last Name:STUTHEIT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:440 HOMETOWN PLAZA DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:OWENSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65066-1596
Mailing Address - Country:US
Mailing Address - Phone:573-437-6100
Mailing Address - Fax:
Practice Address - Street 1:440 HOMETOWN PLAZA DR
Practice Address - Street 2:
Practice Address - City:OWENSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65066-1596
Practice Address - Country:US
Practice Address - Phone:573-437-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019022253207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine