Healthcare Provider Details

I. General information

NPI: 1609318922
Provider Name (Legal Business Name): MEGAN DOHENY MSN, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2016
Last Update Date: 11/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S LAKE PARK AVE SUITE 205
HOBART IN
46342-6790
US

IV. Provider business mailing address

1400 S LAKE PARK AVE SUITE 205
HOBART IN
46342-6790
US

V. Phone/Fax

Practice location:
  • Phone: 219-942-8620
  • Fax:
Mailing address:
  • Phone: 219-942-8620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number71006703A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: