Healthcare Provider Details

I. General information

NPI: 1831690874
Provider Name (Legal Business Name): MEGAN FARLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2018
Last Update Date: 02/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N SHORTRIDGE RD
INDIANAPOLIS IN
46219-4911
US

IV. Provider business mailing address

100 N BREWER ST
GREENWOOD IN
46142-3503
US

V. Phone/Fax

Practice location:
  • Phone: 317-554-8085
  • Fax:
Mailing address:
  • Phone: 317-502-5864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: