Healthcare Provider Details

I. General information

NPI: 1912687575
Provider Name (Legal Business Name): MEGHAN ELIZABETH MCNEILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 WOOD RD STE 101
BRAINTREE MA
02184-2404
US

IV. Provider business mailing address

PO BOX 68
S WEYMOUTH MA
02190-0001
US

V. Phone/Fax

Practice location:
  • Phone: 781-843-0705
  • Fax:
Mailing address:
  • Phone: 781-803-2786
  • Fax: 781-812-1631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN2316804
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: