Healthcare Provider Details

I. General information

NPI: 1922137744
Provider Name (Legal Business Name): MEGAN LYNN NUGENT M.A., CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

637 S STATE ROAD 135 SUITE C
GREENWOOD IN
46142-1443
US

IV. Provider business mailing address

149 HAWTHORNE LN
GREENWOOD IN
46142-9430
US

V. Phone/Fax

Practice location:
  • Phone: 317-865-1110
  • Fax: 317-865-0221
Mailing address:
  • Phone: 317-300-0186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number46001680A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: