Healthcare Provider Details

I. General information

NPI: 1821500976
Provider Name (Legal Business Name): KEVIN T. MEIGHAN RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 10/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 GOVERNMENT CRICLE
BROWNING MT
59417
US

IV. Provider business mailing address

PO BOX 2971
BROWNING MT
59417-2971
US

V. Phone/Fax

Practice location:
  • Phone: 406-338-6192
  • Fax: 406-338-6384
Mailing address:
  • Phone: 715-467-1223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number166506-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: