Healthcare Provider Details

I. General information

NPI: 1154389823
Provider Name (Legal Business Name): MEGAN A DUFFY CNMW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 09/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 CHESTNUT ST FL 1
PHILADELPHIA PA
19107-4404
US

IV. Provider business mailing address

833 CHESTNUT ST FL 1
PHILADELPHIA PA
19107-4404
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-5000
  • Fax: 215-923-1089
Mailing address:
  • Phone: 215-955-6776
  • Fax: 215-955-4020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberMW010008
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: