Healthcare Provider Details

I. General information

NPI: 1982072237
Provider Name (Legal Business Name): MEGAN MAXINE RUOPP ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2015
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3419 16TH AVE SW STE 100
CEDAR RAPIDS IA
52404-2326
US

IV. Provider business mailing address

PO BOX 746870
ATLANTA GA
30374-6870
US

V. Phone/Fax

Practice location:
  • Phone: 319-206-9561
  • Fax: 319-423-7978
Mailing address:
  • Phone: 773-352-1515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA116169
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: