Healthcare Provider Details

I. General information

NPI: 1831033091
Provider Name (Legal Business Name): MEGAN G ANDERSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

657 2ND AVE N
FARGO ND
58102-4727
US

IV. Provider business mailing address

4229 41ST AVE S
MOORHEAD MN
56560-7513
US

V. Phone/Fax

Practice location:
  • Phone: 701-232-3241
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2005443
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR35429
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: