Healthcare Provider Details
I. General information
NPI: 1104537232
Provider Name (Legal Business Name): MEGHAN HITE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/09/2022
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1100 36TH AVE
MOLINE IL
61265-7127
US
IV. Provider business mailing address
1100 36TH AVE
MOLINE IL
61265-7127
US
V. Phone/Fax
- Phone: 309-743-6700
- Fax: 309-764-2042
- Phone: 309-743-6700
- Fax: 309-764-2042
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 209026548 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: