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General NPI Number Information
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NPI Number | 1699158857
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Entity Type | Individual
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Provider Name | MEEGAN RYAN GREGG NP
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Gender | Female
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 940 DISC DR
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City | SCOTTS VALLEY
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State | CA
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Zip | 95066-4544
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Country | US
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Telephone | 831-430-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 611A BAYVIEW DR
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City | APTOS
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State | CA
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Zip | 95003-5303
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Country | US
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Telephone | 831-277-9759
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 22176
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 783783
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License Number State | CA
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