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NPI Code Detail

MEDICARE: MEGAN BRADY HERRING

MEDICARE: MEGAN BRADY HERRING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1104680305
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN BRADY HERRING
Provider Business Mailing Address
First Line : P.O. DRAWER 2109
Second Line :
City : RUSSELLVILLE
State : AR
Zip : 72811-2109
Country : US
Telephone Number : 479-967-2322
Fax Number : 479-967-2876
Provider Business Practice Location Address
First Line : 3605 W SOUTHERN HILLS BLVD STE 300
Second Line :
City : ROGERS
State : AR
Zip : 72758-8265
Country : US
Telephone Number : 479-967-2322
Fax Number : 479-967-2876
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2024
Last Update Date : 02/08/2024

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