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NPI Code Detail

MEDICARE: MEGAN ELIZABETH EWERS

MEDICARE: MEGAN ELIZABETH EWERS
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1316687221
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN ELIZABETH EWERS
Provider Business Mailing Address
First Line : 5868 BAKER RD
Second Line :
City : MINNETONKA
State : MN
Zip : 55345-5903
Country : US
Telephone Number : 952-727-4200
Fax Number :
Provider Business Practice Location Address
First Line : 10180 VIKING DR
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55344-7207
Country : US
Telephone Number : 952-727-4200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2022
Last Update Date : 03/30/2022

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