MEDICARE: MEGHAN TRIPP

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	174H00000X	Health Educator

General Provider Information

NPI Number	:	1619479805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN TRIPP

Provider Business Mailing Address
First Line	:	8519 COLONY TRACE DR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-7678
Country	:	US
Telephone Number	:	239-222-0614
Fax Number	:

Provider Business Practice Location Address
First Line	:	1360 ROYAL PALM SQUARE BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-1077
Country	:	US
Telephone Number	:	239-275-9622
Fax Number	:

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

Provider Enumeration Date	:	03/02/2018
Last Update Date	:	03/02/2018

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Directions to “ MEGHAN TRIPP ” Practice Location

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