Healthcare Provider Details

I. General information

NPI: 1508693862
Provider Name (Legal Business Name): MEGAN ANN MARION GALSTAD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2024
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 ANNE ST NW
BEMIDJI MN
56601-5113
US

IV. Provider business mailing address

8469 CHAMBERLAIN LN NW
BEMIDJI MN
56601-8552
US

V. Phone/Fax

Practice location:
  • Phone: 218-755-6063
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number2490648
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberR54562
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: