MEDICARE: MEGAN DUDEN

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	2255A2300X	Athletic Trainer	2013037385	MO

General Provider Information

NPI Number	:	1861997439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN DUDEN

Provider Business Mailing Address
First Line	:	6308 HEDGE LANE TER APT 202
Second Line	:
City	:	SHAWNEE
State	:	KS
Zip	:	66226-4823
Country	:	US
Telephone Number	:	913-530-1084
Fax Number	:

Provider Business Practice Location Address
First Line	:	6301 N LUCERNE AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64151-3105
Country	:	US
Telephone Number	:	816-569-1802
Fax Number	:

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

Provider Enumeration Date	:	03/27/2018
Last Update Date	:	03/27/2018

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Directions to “ MEGAN DUDEN ” Practice Location

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