Healthcare Provider Details

I. General information

NPI: 1497676746
Provider Name (Legal Business Name): MEGAN NICOLE CARNUCHE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 ENCLAVE DR
NEW CASTLE PA
16105-3207
US

IV. Provider business mailing address

3011 SUZANNE DR
ERIE PA
16510-4481
US

V. Phone/Fax

Practice location:
  • Phone: 724-654-4118
  • Fax:
Mailing address:
  • Phone: 724-714-9529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: