Healthcare Provider Details

I. General information

NPI: 1427735604
Provider Name (Legal Business Name): MEGAN EADS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2023
Last Update Date: 06/29/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2044 MESA PALMS DR
ST GEORGE UT
84770-5546
US

IV. Provider business mailing address

2044 MESA PALMS DR
ST GEORGE UT
84770-5546
US

V. Phone/Fax

Practice location:
  • Phone: 801-628-2936
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number75196623102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: