Healthcare Provider Details

I. General information

NPI: 1346166840
Provider Name (Legal Business Name): MEAGAN WHITBY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 CHERE CAROL RD
HUMBOLDT TN
38343-3634
US

IV. Provider business mailing address

414 FEATHERSTONE CV
MEDINA TN
38355-6928
US

V. Phone/Fax

Practice location:
  • Phone: 731-784-7833
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number41711
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: