Provider Demographics
NPI:1366223034
Name:O'SHEA, MEGAN (FNP-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:O'SHEA
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 1:1401 SUNDT LN
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:WI
Mailing Address - Zip Code:53589-1068
Mailing Address - Country:US
Mailing Address - Phone:608-719-8032
Mailing Address - Fax:
Practice Address - Street 1:6000 MONONA DR STE 203
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53716-3329
Practice Address - Country:US
Practice Address - Phone:608-419-7048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14616-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily