Healthcare Provider Details

I. General information

NPI: 1467018606
Provider Name (Legal Business Name): MEGAN ADAMS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2019
Last Update Date: 06/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 LAKEVIEW CIR STE A
COVINGTON LA
70433-7521
US

IV. Provider business mailing address

649 PLACE SAINT ETIENNE
COVINGTON LA
70433-8138
US

V. Phone/Fax

Practice location:
  • Phone: 985-643-0075
  • Fax: 985-646-0430
Mailing address:
  • Phone: 713-410-5521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number204306
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: