MEDICARE: MEGAN ENYART NP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	118628	WV
2	363L00000X	Nurse Practitioner	3013432	KY
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	3013432	KY

General Provider Information

NPI Number	:	1669033734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN ENYART NP

Provider Business Mailing Address
First Line	:	600 SAINT CHRISTOPHER DR
Second Line	:
City	:	ASHLAND
State	:	KY
Zip	:	41101-7026
Country	:	US
Telephone Number	:	606-922-0695
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 SAINT CHRISTOPHER DR
Second Line	:
City	:	ASHLAND
State	:	KY
Zip	:	41101-7026
Country	:	US
Telephone Number	:	606-922-0695
Fax Number	:

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

Provider Enumeration Date	:	06/27/2019
Last Update Date	:	09/17/2024

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