MEDICARE: MEGAN D PHILLIPS RN

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	163WE0003X	Emergency Registered Nurse	984469	TX

General Provider Information

NPI Number	:	1760345938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN D PHILLIPS RN

Provider Business Mailing Address
First Line	:	134 BLACK FOREST DR
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76086-5916
Country	:	US
Telephone Number	:	682-333-9914
Fax Number	:

Provider Business Practice Location Address
First Line	:	5900 S HULEN ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4820
Country	:	US
Telephone Number	:	817-752-2171
Fax Number	:

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

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	12/04/2025

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