MEDICARE: MEGAN MARIE SREDL MSN, FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	5020520	NC

General Provider Information

NPI Number	:	1407685019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN MARIE SREDL MSN, FNP-BC

Provider Business Mailing Address
First Line	:	4736 ROYAL TROON DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27604-5844
Country	:	US
Telephone Number	:	408-833-8382
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 BLUE RIDGE RD STE 200D
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-7515
Country	:	US
Telephone Number	:	919-784-2057
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2024
Last Update Date	:	09/24/2024

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