Healthcare Provider Details

I. General information

NPI: 1467376772
Provider Name (Legal Business Name): MEGAN ANTHONY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 N CEDAR AVE STE 1
OWATONNA MN
55060-2306
US

IV. Provider business mailing address

411 WALNUT ST # 23368
GREEN COVE SPRINGS FL
32043-3443
US

V. Phone/Fax

Practice location:
  • Phone: 360-375-2240
  • Fax:
Mailing address:
  • Phone: 360-375-2240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MEGAN DANIELLE ANTHONY
Title or Position: OWNER
Credential: DO
Phone: 360-375-2240