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General NPI Number Information
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NPI Number | 1982465373
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Entity Type | Individual
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Provider Name | MEGAN CLATWORTHY FNP
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Gender | Female
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Dates
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Enumeration Date | 01/22/2024
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 422 KINETIC PARK DRIVE SUITE B
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City | HUNTINGTON
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State | WV
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Zip | 25701
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Country | US
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Telephone | 304-523-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 125 N QUEENS CT
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City | HUNTINGTON
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State | WV
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Zip | 25705-3735
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Country | US
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Telephone | 304-382-5118
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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 | 106124
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License Number State | WV
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