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General NPI Number Information
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NPI Number | 1285392951
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Entity Type | Individual
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Provider Name | MEGAN LIGHT FNP
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Gender | Female
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Dates
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Enumeration Date | 11/30/2021
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 110 BROADWAY
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City | BUCKSPORT
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State | ME
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Zip | 04416-4612
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Country | US
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Telephone | 615-212-0920
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Fax |
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Provider Business Mailing Address
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Address Line | 110 BROADWAY
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City | BUCKSPORT
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State | ME
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Zip | 04416-4612
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Country | US
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Telephone | 207-469-7371
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 000029778
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License Number State | TN
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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 | 3017602
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN0000029778
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CNP231490
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License Number State | ME
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