Healthcare Provider Details

I. General information

NPI: 1053918714
Provider Name (Legal Business Name): MEGHAN PATRICIA AHEARN-STEVEN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2020
Last Update Date: 05/22/2024
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 DILLON RIDGE RD STE 1200
DILLON CO
80435-6344
US

IV. Provider business mailing address

PO BOX 4330
AVON CO
81620-4330
US

V. Phone/Fax

Practice location:
  • Phone: 970-926-6340
  • Fax:
Mailing address:
  • Phone: 970-926-6340
  • Fax: 970-926-6348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA8493
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: