Healthcare Provider Details

I. General information

NPI: 1700697968
Provider Name (Legal Business Name): MEGAN MARIE SCHALK APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2616 LEGENDS WAY
CRESTVIEW HILLS KY
41017-2418
US

IV. Provider business mailing address

2616 LEGENDS WAY
CRESTVIEW HILLS KY
41017-2418
US

V. Phone/Fax

Practice location:
  • Phone: 859-331-3100
  • Fax:
Mailing address:
  • Phone: 859-331-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4034053
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4034053
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: