Healthcare Provider Details

I. General information

NPI: 1306255948
Provider Name (Legal Business Name): MEGAN NOELANI DURKIN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2014
Last Update Date: 09/22/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1608 S J ST FL 3
TACOMA WA
98405-4930
US

IV. Provider business mailing address

1608 S J ST FL 3
TACOMA WA
98405-4930
US

V. Phone/Fax

Practice location:
  • Phone: 253-274-7503
  • Fax:
Mailing address:
  • Phone: 253-274-7503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP60490360
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP60490360
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: