Healthcare Provider Details

I. General information

NPI: 1841753621
Provider Name (Legal Business Name): MEGAN QUIGLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 04/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E OAK AVE
TAMPA FL
33602-2210
US

IV. Provider business mailing address

6533 NASHVILLE AVE
SAINT LOUIS MO
63139-3426
US

V. Phone/Fax

Practice location:
  • Phone: 813-224-9662
  • Fax:
Mailing address:
  • Phone: 303-263-7527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: