Healthcare Provider Details

I. General information

NPI: 1538030606
Provider Name (Legal Business Name): MEGAN HALLETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S STATE ST
ANN ARBOR MI
48109-1382
US

IV. Provider business mailing address

500 S STATE ST
ANN ARBOR MI
48109-1382
US

V. Phone/Fax

Practice location:
  • Phone: 734-764-1817
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN10033269
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: