MEDICARE: MEGAN KENNY APRN

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	163W00000X	Registered Nurse	274934	AZ
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	12250	CT
3	163W00000X	Registered Nurse	208392	CT
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	G178539	IA
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	25964RX	SC
6	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	CP003150	SD
7	163W00000X	Registered Nurse	25964A	SC
8	163WP0808X	Psychiatric/Mental Health Registered Nurse	041389955	IL
9	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	274934	AZ
10	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN03990	RI
11	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	216804	OK
12	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	227002530	IL
13	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11022297	FL

General Provider Information

NPI Number	:	1194199331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN KENNY APRN

Provider Business Mailing Address
First Line	:	254 OLEANDER MILL DR
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29229-7138
Country	:	US
Telephone Number	:	708-955-5354
Fax Number	:

Provider Business Practice Location Address
First Line	:	2093 PHILADELPHIA PIKE # 9898
Second Line	:
City	:	CLAYMONT
State	:	DE
Zip	:	19703-2424
Country	:	US
Telephone Number	:	415-651-3458
Fax Number	:	630-646-6542

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

Provider Enumeration Date	:	11/27/2015
Last Update Date	:	11/14/2025

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