Healthcare Provider Details

I. General information

NPI: 1790275634
Provider Name (Legal Business Name): MEGAN ELIZABETH NIELSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEGAN RAHILL

II. Dates (important events)

Enumeration Date: 05/16/2018
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 SEMINOLE DR
ERIE PA
16505
US

IV. Provider business mailing address

610 SEMINOLE DR
ERIE PA
16505-5037
US

V. Phone/Fax

Practice location:
  • Phone: 814-860-6735
  • Fax:
Mailing address:
  • Phone: 814-860-6735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN648424
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN648424
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: