Healthcare Provider Details

I. General information

NPI: 1689046161
Provider Name (Legal Business Name): MEAGAN LYNN OGUNRINDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEAGAN LYNN AURANDT CRNA

II. Dates (important events)

Enumeration Date: 10/23/2015
Last Update Date: 10/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 BROCKVIEW CENTRE WAY SUITE 400
KNOXVILLE TN
37919
US

IV. Provider business mailing address

30480 SW BOONES FERRY RD APT 316
WILSONVILLE OR
97070-6814
US

V. Phone/Fax

Practice location:
  • Phone: 561-623-2035
  • Fax:
Mailing address:
  • Phone: 412-951-3822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number20150118RN
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number752036
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number201503992CRNA
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: