MEDICARE: MEGAN AUGUSTINE FNP-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	363LF0000X	Family Nurse Practitioner	2015028835	MO
2	363LF0000X	Family Nurse Practitioner	53-84874-091	KS

General Provider Information

NPI Number	:	1558737874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN AUGUSTINE FNP-C

Provider Business Mailing Address
First Line	:	210 NE TUDOR RD
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64086-5696
Country	:	US
Telephone Number	:	888-256-3814
Fax Number	:	888-256-9054

Provider Business Practice Location Address
First Line	:	5506 CORPORATE DR STE 1600
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64507-7765
Country	:	US
Telephone Number	:	816-271-7848
Fax Number	:	816-271-7751

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

Provider Enumeration Date	:	08/20/2015
Last Update Date	:	12/08/2025

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