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General NPI Number Information
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NPI Number | 1235439761
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Entity Type | Individual
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Provider Name | MEGHAN MARIE CEYNOWA NP
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Gender | Female
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Dates
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Enumeration Date | 11/01/2010
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Last Update Date | 11/01/2010
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Provider Practice Location Address
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Address Line | 220 N 6TH AVE E
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City | DULUTH
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State | MN
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Zip | 55805-1952
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Country | US
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Telephone | 218-249-7000
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Fax | 218-249-7050
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Provider Business Mailing Address
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Address Line | 220 N 6TH AVE E
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City | DULUTH
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State | MN
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Zip | 55805-1952
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Country | US
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Telephone | 218-249-7000
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Fax | 218-249-7050
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 158881-9
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License Number State | MN
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