Healthcare Provider Details
I. General information
NPI: 1295310779
Provider Name (Legal Business Name): MEGHAN A VICARS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/16/2021
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5255 LOUGHBORO RD NW
WASHINGTON DC
20016-2633
US
IV. Provider business mailing address
6214 HOMESPUN LN
FALLS CHURCH VA
22044-1012
US
V. Phone/Fax
- Phone: 202-660-6500
- Fax: 805-879-5692
- Phone: 703-628-8351
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | 0024180452 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | NP1050043 |
| License Number State | DC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: