Healthcare Provider Details

I. General information

NPI: 1013562545
Provider Name (Legal Business Name): MEAGAN CARSON RN, PMHNP, DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2019
Last Update Date: 11/18/2022
Certification Date: 11/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 20TH STREET NORTH, SUITE 2200, OFFICE #2210
BIRMINGHAM AL
35203
US

IV. Provider business mailing address

420 20TH STREET NORTH, SUITE 2200, OFFICE #2210
BIRMINGHAM AL
35203
US

V. Phone/Fax

Practice location:
  • Phone: 205-862-6362
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1-159559
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number1-159559
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: