Healthcare Provider Details

I. General information

NPI: 1700513868
Provider Name (Legal Business Name): MEGAN ALLISON LAWLESS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2022
Last Update Date: 09/21/2022
Certification Date: 09/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 LINDEN AVE FL 9
BALTIMORE MD
21201-4622
US

IV. Provider business mailing address

1733 E PRATT ST
BALTIMORE MD
21231-1819
US

V. Phone/Fax

Practice location:
  • Phone: 443-552-2539
  • Fax:
Mailing address:
  • Phone: 23-750-7839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR220448
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR220448
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: