Healthcare Provider Details

I. General information

NPI: 1346765526
Provider Name (Legal Business Name): MEAGAN DEAR PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2017
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

582 LAKELAND EAST DR STE C
FLOWOOD MS
39232-9025
US

IV. Provider business mailing address

582 LAKELAND EAST DR STE C
FLOWOOD MS
39232-9025
US

V. Phone/Fax

Practice location:
  • Phone: 601-654-7011
  • Fax: 601-429-1716
Mailing address:
  • Phone: 601-654-7011
  • Fax: 601-429-1716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number902186
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: