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NPI Code Detail

MEDICARE: MEGHAN MASK

MEDICARE: MEGHAN MASK
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
1363LF0000XFamily Nurse Practitioner218889AR

General Provider Information

NPI Number : 1679226708
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGHAN MASK
Provider Business Mailing Address
First Line : 27 W TOWNSHIP ST
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-2821
Country : US
Telephone Number : 479-900-5692
Fax Number :
Provider Business Practice Location Address
First Line : 27 W TOWNSHIP ST
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-2821
Country : US
Telephone Number : 479-900-5692
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2022
Last Update Date : 07/10/2025

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Directions to “ MEGHAN MASK ” Practice Location

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