Healthcare Provider Details

I. General information

NPI: 1184928137
Provider Name (Legal Business Name): MRS. MEAGAN LYNNE GUENTHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS MEAGAN LYNNE PLUMMER

II. Dates (important events)

Enumeration Date: 01/05/2011
Last Update Date: 01/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST MGH DEPT OF ANESTHESIA, GREY-BIGELOW 444
BOSTON MA
02114-2621
US

IV. Provider business mailing address

108 FOGG WAY
HINGHAM MA
02043-1628
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-3030
  • Fax:
Mailing address:
  • Phone: 978-376-5895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN256468
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: