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NPI Code Detail

MEDICARE: MISS MEGHAN ELIZABETH HENDERSHOT FNP-BC

MEDICARE: MISS MEGHAN ELIZABETH HENDERSHOT FNP-BC
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
1163WX0200XOncology Registered Nurse4704354336MI

General Provider Information

NPI Number : 1497435747
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MEGHAN ELIZABETH HENDERSHOT FNP-BC
Provider Business Mailing Address
First Line : 6734 LAKEWAY ST
Second Line :
City : YPSILANTI
State : MI
Zip : 48197-1054
Country : US
Telephone Number : 734-645-8125
Fax Number :
Provider Business Practice Location Address
First Line : 1275 YORK AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10065-6007
Country : US
Telephone Number : 212-639-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2023
Last Update Date : 07/21/2023

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