Healthcare Provider Details

I. General information

NPI: 1922677822
Provider Name (Legal Business Name): MEGAN K DUNKIN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 OAK GROVE RD
POPLAR BLUFF MO
63901-1573
US

IV. Provider business mailing address

2541 STONE RIDGE DR
POPLAR BLUFF MO
63901-2169
US

V. Phone/Fax

Practice location:
  • Phone: 573-776-2000
  • Fax:
Mailing address:
  • Phone: 573-300-5652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06212100
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: