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General NPI Number Information
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NPI Number | 1134768310
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Entity Type | Individual
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Provider Name | MEGAN ELIZABETH MACKLE MSN, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/05/2020
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Last Update Date | 03/29/2020
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Provider Practice Location Address
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Address Line | 4048 DRESSLER RD NW
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City | CANTON
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State | OH
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Zip | 44718-2784
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Country | US
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Telephone | 330-479-3333
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Fax |
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Provider Business Mailing Address
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Address Line | 4048 DRESSLER RD NW STE 100
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City | CANTON
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State | OH
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Zip | 44718-2784
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Country | US
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Telephone | 330-479-3333
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Fax | 330-479-3334
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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 | 163WM0102X
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Taxonomy Name | Maternal Newborn Registered Nurse
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License Number | RN.357958
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.026316
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License Number State | OH
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