Healthcare Provider Details

I. General information

NPI: 1427474824
Provider Name (Legal Business Name): MEGAN B SANDERS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2014
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4610 S 133RD ST STE 109
OMAHA NE
68137-1133
US

IV. Provider business mailing address

4610 S 133RD ST STE 109
OMAHA NE
68137-1133
US

V. Phone/Fax

Practice location:
  • Phone: 402-614-0010
  • Fax: 402-614-0090
Mailing address:
  • Phone: 402-614-0010
  • Fax: 402-614-0090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number111753
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: