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General NPI Number Information
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NPI Number | 1871276113
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Entity Type | Individual
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Provider Name | MEAGAN PETERSEN APRN
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Gender | Female
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Dates
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Enumeration Date | 08/14/2023
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 101 NOAHS LN
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-5380
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Country | US
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Telephone | 812-282-8479
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Fax |
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Provider Business Mailing Address
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Address Line | 6027 COOKIE DR
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City | CHARLESTOWN
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State | IN
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Zip | 47111-7729
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Country | US
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Telephone | 812-406-6808
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 71014199A
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License Number State | IN
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