MEDICARE: MRS. MEAGHAN STIPO AGNP-C

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
1	363LA2200X	Adult Health Nurse Practitioner	26NJ00784800	NJ

General Provider Information

NPI Number	:	1174039465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MEAGHAN STIPO AGNP-C

Provider Business Mailing Address
First Line	:	10 MEADOWVIEW TER
Second Line	:
City	:	RINGWOOD
State	:	NJ
Zip	:	07456-1124
Country	:	US
Telephone Number	:	516-448-5271
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 UNION VALLEY RD
Second Line	:
City	:	HEWITT
State	:	NJ
Zip	:	07421-3024
Country	:	US
Telephone Number	:	973-706-8535
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2017
Last Update Date	:	01/14/2026

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