Healthcare Provider Details

I. General information

NPI: 1053181149
Provider Name (Legal Business Name): MEGAN SPARLING FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8800 COMMERCE RD
COMMERCE TWP MI
48382-4413
US

IV. Provider business mailing address

21893 LEYTE ST
FARMINGTON HILLS MI
48336-6038
US

V. Phone/Fax

Practice location:
  • Phone: 248-363-7500
  • Fax: 248-363-7700
Mailing address:
  • Phone: 248-891-5274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704342959
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: