Healthcare Provider Details

I. General information

NPI: 1871135962
Provider Name (Legal Business Name): MEAGAN PLATT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2019
Last Update Date: 09/08/2023
Certification Date: 09/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 S MAIN ST FL 3
WEST HARTFORD CT
06107-2486
US

IV. Provider business mailing address

24 LANZ LN
ELLINGTON CT
06029-2312
US

V. Phone/Fax

Practice location:
  • Phone: 860-247-2530
  • Fax: 860-524-7724
Mailing address:
  • Phone: 860-604-3898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number71614
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8491
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: