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General NPI Number Information
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NPI Number | 1235588542
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Entity Type | Individual
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Provider Name | MEGAN LEE GORST NP-C
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Gender | Female
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Dates
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Enumeration Date | 06/07/2016
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 14845 MOUNT EDEN RD
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City | MOUNT EDEN
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State | KY
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Zip | 40046-7001
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Country | US
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Telephone | 480-255-9655
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Fax | 480-530-9477
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Provider Business Mailing Address
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Address Line | 14845 MOUNT EDEN RD
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City | MOUNT EDEN
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State | KY
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Zip | 40046-7001
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Country | US
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Telephone | 480-255-9655
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Fax |
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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 | 3015736
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 225172
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 225172
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License Number State | AZ
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