Healthcare Provider Details

I. General information

NPI: 1255071627
Provider Name (Legal Business Name): MEGAN EILEEN RODGERS TSCHANNEN PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 E LOCKLING ST
BROOKFIELD MO
64628-2337
US

IV. Provider business mailing address

302 N 3RD ST APT 716
SAINT JOSEPH MO
64501-1877
US

V. Phone/Fax

Practice location:
  • Phone: 660-258-1050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2022010800
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: