Healthcare Provider Details

I. General information

NPI: 1114893799
Provider Name (Legal Business Name): MEGAN NUFFER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/24/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

771 AIRPORT BLVD
ANN ARBOR MI
48108-1639
US

IV. Provider business mailing address

8181 TWILIGHT LN
BRIGHTON MI
48116-8545
US

V. Phone/Fax

Practice location:
  • Phone: 734-213-8011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number5351018761
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: