Healthcare Provider Details

I. General information

NPI: 1912724261
Provider Name (Legal Business Name): MEAGAN ELLIOTT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2024
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22660 CANAL RD
ORANGE BEACH AL
36561-3801
US

IV. Provider business mailing address

21001 RACHEL MYERS LN
FAIRHOPE AL
36532-4627
US

V. Phone/Fax

Practice location:
  • Phone: 251-986-2696
  • Fax:
Mailing address:
  • Phone: 770-530-8876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-149508
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License Number1-149508
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: