Healthcare Provider Details

I. General information

NPI: 1821835125
Provider Name (Legal Business Name): MEGAN KUIKEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2024
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 PARK ST
OGDENSBURG NY
13669-3911
US

IV. Provider business mailing address

6473 STATE HIGHWAY 56
POTSDAM NY
13676-3479
US

V. Phone/Fax

Practice location:
  • Phone: 315-713-9090
  • Fax: 315-713-9330
Mailing address:
  • Phone: 315-268-1312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number901825
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: