Healthcare Provider Details

I. General information

NPI: 1790137875
Provider Name (Legal Business Name): MEGHAN THEURER APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGHAN MCDANIEL

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3149 BOBCAT VILLAGE CENTER RD
NORTH PORT FL
34288-8974
US

IV. Provider business mailing address

3149 BOBCAT VILLAGE CENTER RD
NORTH PORT FL
34288-8974
US

V. Phone/Fax

Practice location:
  • Phone: 941-266-5629
  • Fax:
Mailing address:
  • Phone: 941-266-5629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN.CNP.022752
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: