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General NPI Number Information
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NPI Number | 1437675030
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Entity Type | Individual
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Provider Name | MEGAN TIARA WASSERMAN FNP
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Gender | Female
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Dates
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Enumeration Date | 08/16/2017
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | 860 POTOMAC CIR
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City | AURORA
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State | CO
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Zip | 80011-6714
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Country | US
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Telephone | 720-777-2248
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Fax |
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Provider Business Mailing Address
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Address Line | 2417 CENTRAL PARK BLVD
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City | DENVER
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State | CO
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Zip | 80238-2899
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Country | US
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Telephone |
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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 | APN.0993237-NP
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | APN.0993237-NP
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License Number State | CO
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