Healthcare Provider Details

I. General information

NPI: 1346064219
Provider Name (Legal Business Name): MEAGAN MICHELLE FLAHERTY CPM, LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2024
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13175 TRACK LN
SMITHFIELD VA
23430-3803
US

IV. Provider business mailing address

13175 TRACK LN
SMITHFIELD VA
23430-3803
US

V. Phone/Fax

Practice location:
  • Phone: 804-684-1748
  • Fax:
Mailing address:
  • Phone: 804-684-1748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number0129000209
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: