Healthcare Provider Details

I. General information

NPI: 1508262353
Provider Name (Legal Business Name): MEAGHAN KRAJEWSKI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2014
Last Update Date: 11/29/2023
Certification Date: 11/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 WILLIMANSETT ST STE C
SOUTH HADLEY MA
01075-3097
US

IV. Provider business mailing address

123 SUMMER ST # 690
WORCESTER MA
01608-1216
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-9650
  • Fax:
Mailing address:
  • Phone: 508-363-9530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN282603
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number5972
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: