MEDICARE: MEGAN JILL EAGLE APRN-BC, MSN, FNP

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	363LF0000X	Family Nurse Practitioner	4704196737	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	5008665780	OTHER	MI	BLUE CROSS BLUE SHEILD MI

General Provider Information

NPI Number	:	1962509539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN JILL EAGLE APRN-BC, MSN, FNP

Provider Business Mailing Address
First Line	:	1230 N MAPLE RD
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-2842
Country	:	US
Telephone Number	:	734-998-6117
Fax Number	:	734-998-7163

Provider Business Practice Location Address
First Line	:	1230 N MAPLE RD
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-2842
Country	:	US
Telephone Number	:	734-998-6117
Fax Number	:	734-998-7163

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

Provider Enumeration Date	:	09/17/2006
Last Update Date	:	01/21/2011

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