Healthcare Provider Details

I. General information

NPI: 1184537847
Provider Name (Legal Business Name): MEGAN LEEANN TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5717 S 112TH ST
OMAHA NE
68137-3652
US

IV. Provider business mailing address

6320 S 143RD ST
OMAHA NE
68137-4811
US

V. Phone/Fax

Practice location:
  • Phone: 402-715-2350
  • Fax:
Mailing address:
  • Phone: 402-715-2351
  • Fax: 402-715-2358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: