Healthcare Provider Details

I. General information

NPI: 1750852646
Provider Name (Legal Business Name): MEGAN ANNE CASEY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2018
Last Update Date: 12/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8730 STONY POINT PKWY STE 120
RICHMOND VA
23235-1959
US

IV. Provider business mailing address

220 JAMES RIVER DR
NEWPORT NEWS VA
23601-3618
US

V. Phone/Fax

Practice location:
  • Phone: 804-775-4559
  • Fax:
Mailing address:
  • Phone: 757-871-8780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024176887
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: