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General NPI Number Information
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NPI Number | 1114559846
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Entity Type | Individual
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Provider Name | MEGHAN C SHANK PMHNP
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Gender | Female
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Dates
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Enumeration Date | 02/11/2020
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Last Update Date | 11/18/2022
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Provider Practice Location Address
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Address Line | 18 E 48TH ST RM 1202
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City | NEW YORK
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State | NY
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Zip | 10017-1038
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Country | US
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Telephone | 646-846-0139
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Fax |
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Provider Business Mailing Address
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Address Line | 1355 BEVERLY ROAD SUITE 225
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City | MCLEAN
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State | VA
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Zip | 22101
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Country | US
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Telephone | 703-408-7327
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Fax | 571-297-6277
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024181416
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R230592
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F404458-01
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License Number State | NY
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