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General NPI Number Information
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NPI Number | 1497077440
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Entity Type | Individual
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Provider Name | MEGAN OTT LEWIS CPNP
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Gender | Female
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Dates
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Enumeration Date | 02/18/2010
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Last Update Date | 10/06/2016
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Provider Practice Location Address
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Address Line | 3550 MARKET ST RM 30249
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City | PHILADELPHIA
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State | PA
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Zip | 19104-3329
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Country | US
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Telephone | 215-590-2549
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Fax |
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Provider Business Mailing Address
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Address Line | 3550 MARKET ST RM 3026
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City | PHILADELPHIA
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State | PA
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Zip | 19104-3329
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Country | US
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Telephone | 267-426-5856
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | SP010723
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License Number State | PA
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