Healthcare Provider Details

I. General information

NPI: 1447762679
Provider Name (Legal Business Name): MEGAN STAFEIL NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2017
Last Update Date: 10/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

853 JEFFERSON AVE # E206
MEMPHIS TN
38103-2807
US

IV. Provider business mailing address

1686 LAUREL KNOLL CIR
GERMANTOWN TN
38139-6971
US

V. Phone/Fax

Practice location:
  • Phone: 901-448-6728
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number23504
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: