Healthcare Provider Details

I. General information

NPI: 1851468037
Provider Name (Legal Business Name): MEGAN KATHLEEN WACKER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN KATHLEEN ROTH RNC, NP

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 S 18TH ST
COLUMBUS OH
43205-2654
US

IV. Provider business mailing address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-2000
  • Fax:
Mailing address:
  • Phone: 614-722-2000
  • Fax: 614-722-4565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN.CNP.020976
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: