Healthcare Provider Details

I. General information

NPI: 1558775163
Provider Name (Legal Business Name): MEGAN NICOLE RHYNE-COUSAR NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2014
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15720 BRIXHAM HILL AVE STE 300
CHARLOTTE NC
28277-4784
US

IV. Provider business mailing address

11001 HAT CREEK LN
DAVIDSON NC
28036-9606
US

V. Phone/Fax

Practice location:
  • Phone: 415-671-2165
  • Fax:
Mailing address:
  • Phone: 704-490-2756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5006918
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number5006918
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number5006918
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5006918
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5006918
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: