Healthcare Provider Details

I. General information

NPI: 1588384218
Provider Name (Legal Business Name): MEGHANN NOONAN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2022
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 CHEW ST
ALLENTOWN PA
18102-3406
US

IV. Provider business mailing address

801 OSTRUM ST
BETHLEHEM PA
18015-1000
US

V. Phone/Fax

Practice location:
  • Phone: 484-822-5700
  • Fax: 484-822-5796
Mailing address:
  • Phone: 484-526-4999
  • Fax: 833-213-6428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP026208
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: