Healthcare Provider Details

I. General information

NPI: 1902376601
Provider Name (Legal Business Name): MEGAN MAYNARD APRN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. MEGAN LERAE HORTON

II. Dates (important events)

Enumeration Date: 11/26/2018
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 FLEMINGSBURG RD STE A340
MOREHEAD KY
40351-1015
US

IV. Provider business mailing address

PO BOX 390
HUNTINGTON WV
25708-0390
US

V. Phone/Fax

Practice location:
  • Phone: 606-207-2931
  • Fax: 606-783-0964
Mailing address:
  • Phone: 304-429-1088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3012042
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number4018424
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number114780
License Number StateWV
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number83431
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: