Provider Demographics
NPI:1174901391
Name:MADER, MEGHAN LEIGH (FNP-C)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:LEIGH
Last Name:MADER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 SE 1ST AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0408
Mailing Address - Country:US
Mailing Address - Phone:352-690-6300
Mailing Address - Fax:352-690-6802
Practice Address - Street 1:2801 SE 1ST AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0408
Practice Address - Country:US
Practice Address - Phone:352-690-6300
Practice Address - Fax:352-690-6802
Is Sole Proprietor?:No
Enumeration Date:2015-05-07
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9292280363LF0000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health