Healthcare Provider Details
I. General information
NPI: 1194199331
Provider Name (Legal Business Name): MEGAN KENNY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/27/2015
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2093 PHILADELPHIA PIKE # 9898
CLAYMONT DE
19703-2424
US
IV. Provider business mailing address
254 OLEANDER MILL DR
COLUMBIA SC
29229-7138
US
V. Phone/Fax
- Phone: 415-651-3458
- Fax: 630-646-6542
- Phone: 708-955-5354
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 274934 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 12250 |
| License Number State | CT |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 208392 |
| License Number State | CT |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | G178539 |
| License Number State | IA |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 25964RX |
| License Number State | SC |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | CP003150 |
| License Number State | SD |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 25964A |
| License Number State | SC |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0808X |
| Taxonomy | Psychiatric/Mental Health Registered Nurse |
| License Number | 041389955 |
| License Number State | IL |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 274934 |
| License Number State | AZ |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | APRN03990 |
| License Number State | RI |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 216804 |
| License Number State | OK |
| # 12 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 227002530 |
| License Number State | IL |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | APRN11022297 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
