Healthcare Provider Details

I. General information

NPI: 1518823681
Provider Name (Legal Business Name): MEGAN GAIL MORAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/01/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1702 UNIVERSITY DR S
FARGO ND
58103-4940
US

IV. Provider business mailing address

217 PERRYVILLE RD
REHOBOTH MA
02769-1922
US

V. Phone/Fax

Practice location:
  • Phone: 701-364-8910
  • Fax:
Mailing address:
  • Phone: 508-558-0737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: