Healthcare Provider Details

I. General information

NPI: 1124842950
Provider Name (Legal Business Name): MEGHAN EILEEN HACKETT MSN, CRNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2024
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 CIVIC CENTER BLVD 1-330S PERELMAN CENTER
PHILADELPHIA PA
19104-5127
US

IV. Provider business mailing address

3400 CIVIC CENTER BLVD 1-330S PERELMAN CENTER
PHILADELPHIA PA
19104-5127
US

V. Phone/Fax

Practice location:
  • Phone: 215-662-2737
  • Fax: 215-615-3424
Mailing address:
  • Phone: 215-662-2737
  • Fax: 215-615-3424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP030131
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: