Healthcare Provider Details

I. General information

NPI: 1982722609
Provider Name (Legal Business Name): MEGAN ELIZABETH LIEGO RN, MSN, ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 ATLANTIC AVE
LONG BEACH CA
90806-1701
US

IV. Provider business mailing address

2801 ATLANTIC AVE
LONG BEACH CA
90806-1701
US

V. Phone/Fax

Practice location:
  • Phone: 562-760-6968
  • Fax:
Mailing address:
  • Phone: 562-760-6968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number586085
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: