Provider Demographics
NPI:1366251639
Name:MIHALIK, MEAGAN MARIE (FNP-C)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:MARIE
Last Name:MIHALIK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:MARIE
Other - Last Name:FOURNIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 QUAKER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LEEDS
Mailing Address - State:ME
Mailing Address - Zip Code:04263-3614
Mailing Address - Country:US
Mailing Address - Phone:207-320-5172
Mailing Address - Fax:
Practice Address - Street 1:16 COMMERCE PLZ STE 3A
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:ME
Practice Address - Zip Code:04364-1562
Practice Address - Country:US
Practice Address - Phone:207-377-2111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP241758363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily