Healthcare Provider Details

I. General information

NPI: 1760218804
Provider Name (Legal Business Name): MEGAN MARIE CARR DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2024
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 MICHIGAN ST NW STE 424
GRAND RAPIDS MI
49503-3799
US

IV. Provider business mailing address

109 MICHIGAN ST NW STE 424
GRAND RAPIDS MI
49503-3799
US

V. Phone/Fax

Practice location:
  • Phone: 734-834-9931
  • Fax:
Mailing address:
  • Phone: 734-834-9931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704360451
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: