MEDICARE: MEGHAN DENISE MCCLINTOCK APRN

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	207Q00000X	Family Medicine Physician	84870	KS

General Provider Information

NPI Number	:	1689548810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN DENISE MCCLINTOCK APRN

Provider Business Mailing Address
First Line	:	1880 F AVE
Second Line	:
City	:	WHITE CITY
State	:	KS
Zip	:	66872-9222
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1880 F AVE
Second Line	:
City	:	WHITE CITY
State	:	KS
Zip	:	66872-9222
Country	:	US
Telephone Number	:	785-741-3224
Fax Number	:

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

Provider Enumeration Date	:	10/01/2025
Last Update Date	:	10/10/2025

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