Healthcare Provider Details

I. General information

NPI: 1629497409
Provider Name (Legal Business Name): MEGAN HRIBERNIK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 05/19/2021
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2256 W HILL RD
FLINT MI
48507-4655
US

IV. Provider business mailing address

820 SPRINGER DR
LOMBARD IL
60148-6413
US

V. Phone/Fax

Practice location:
  • Phone: 810-249-7546
  • Fax: 734-464-0335
Mailing address:
  • Phone: 815-744-8554
  • Fax: 630-462-8680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704268904
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: