MEDICARE: MEAGAN CHRISMAN FNP

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	363LF0000X	Family Nurse Practitioner	RN305616	GA

General Provider Information

NPI Number	:	1427855253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEAGAN CHRISMAN FNP

Provider Business Mailing Address
First Line	:	145 RALSTON CT
Second Line	:
City	:	FAYETTEVILLE
State	:	GA
Zip	:	30215-2543
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	874 LANIER AVE W STE 220
Second Line	:
City	:	FAYETTEVILLE
State	:	GA
Zip	:	30214-7659
Country	:	US
Telephone Number	:	788-331-4446
Fax Number	:

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

Provider Enumeration Date	:	02/28/2025
Last Update Date	:	05/09/2025

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