Healthcare Provider Details

I. General information

NPI: 1528686128
Provider Name (Legal Business Name): MEGAN ELIZABETH HARRISON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2020
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 WASHINGTON ST W
CHARLESTON WV
25302-2344
US

IV. Provider business mailing address

108 WASHINGTON ST W
CHARLESTON WV
25302-2344
US

V. Phone/Fax

Practice location:
  • Phone: 304-345-4525
  • Fax: 304-345-4527
Mailing address:
  • Phone: 304-345-4525
  • Fax: 304-345-4527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number92079
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number92079
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: