Healthcare Provider Details

I. General information

NPI: 1023927845
Provider Name (Legal Business Name): MEGAN RILEIGH PEIFER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

772 E BROAD ST
HAZLETON PA
18201-6835
US

IV. Provider business mailing address

95 KNOLL DR
LEHIGHTON PA
18235-9227
US

V. Phone/Fax

Practice location:
  • Phone: 570-501-1242
  • Fax:
Mailing address:
  • Phone: 570-579-6613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP036571
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: