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General NPI Number Information
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NPI Number | 1881783660
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Entity Type | Individual
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Provider Name | MEGAN O'CONNOR GRUGAN CRNP
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Gender | Female
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2701 BLAIR MILL RD SUITE 10
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City | WILLOW GROVE
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State | PA
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Zip | 19090-1041
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Country | US
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Telephone | 215-675-1234
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Fax |
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Provider Business Mailing Address
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Address Line | 115 DAVID RD
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City | BALA CYNWYD
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State | PA
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Zip | 19004-2314
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Country | US
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Telephone | 610-668-2536
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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 | UP004345B
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License Number State | PA
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