Healthcare Provider Details

I. General information

NPI: 1700510005
Provider Name (Legal Business Name): MEGHAN LERI CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2022
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1223 S GEAR AVE
WEST BURLINGTON IA
52655-1682
US

IV. Provider business mailing address

711 S 21ST ST APT 514
PITTSBURGH PA
15203-2484
US

V. Phone/Fax

Practice location:
  • Phone: 319-768-4380
  • Fax:
Mailing address:
  • Phone: 814-573-3957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA187366
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: