MEDICARE: MEGAN NICOLE MCKOWN PA

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	363A00000X	Physician Assistant	2285	WV

General Provider Information

NPI Number	:	1942850151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN NICOLE MCKOWN PA

Provider Business Mailing Address
First Line	:	1000 J D ANDERSON DR STE 401
Second Line	:
City	:	MORGANTOWN
State	:	WV
Zip	:	26505-1238
Country	:	US
Telephone Number	:	304-599-3074
Fax Number	:	304-598-2801

Provider Business Practice Location Address
First Line	:	1000 J D ANDERSON DR STE 401
Second Line	:
City	:	MORGANTOWN
State	:	WV
Zip	:	26505-1238
Country	:	US
Telephone Number	:	304-599-3074
Fax Number	:

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

Provider Enumeration Date	:	09/19/2019
Last Update Date	:	04/13/2023

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