Healthcare Provider Details

I. General information

NPI: 1598605594
Provider Name (Legal Business Name): MEGAN BEULEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2171 W PERSHING ST
APPLETON WI
54914-6075
US

IV. Provider business mailing address

1009 EVANS ST
NEENAH WI
54956-3918
US

V. Phone/Fax

Practice location:
  • Phone: 920-410-3310
  • Fax:
Mailing address:
  • Phone: 920-410-3310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: