Healthcare Provider Details

I. General information

NPI: 1215436480
Provider Name (Legal Business Name): MEAGAN DEMBITZKY RN, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2018
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 LOWELL RD UNIT 17-151
HUDSON NH
03051-4938
US

IV. Provider business mailing address

12 MAIN ST FL 2
LEOMINSTER MA
01453-5517
US

V. Phone/Fax

Practice location:
  • Phone: 978-233-1594
  • Fax: 949-561-4522
Mailing address:
  • Phone: 978-206-8382
  • Fax: 978-546-7656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2313783
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number089799-23
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2313783
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number089799-21
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: