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General NPI Number Information
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NPI Number | 1922507235
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Entity Type | Individual
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Provider Name | MEGAN NICOLE BENNER CPNP
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Gender | Female
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Dates
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Enumeration Date | 02/02/2018
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 605 GLOBAL WAY STE 119
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City | LINTHICUM
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State | MD
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Zip | 21090-2222
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Country | US
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Telephone | 410-789-7337
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Fax | 410-789-0425
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Provider Business Mailing Address
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Address Line | 605 GLOBAL WAY STE 119
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City | LINTHICUM
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State | MD
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Zip | 21090-2222
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Country | US
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Telephone | 667-888-7337
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Fax | 410-789-0425
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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 | R202351
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License Number State | MD
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