Provider Demographics
NPI:1437505013
Name:CLEVELAND, MEGAN (MSN, CNM)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:CLEVELAND
Suffix:
Gender:F
Credentials:MSN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MERCADO ST STE 145
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-7311
Mailing Address - Country:US
Mailing Address - Phone:970-247-5543
Mailing Address - Fax:
Practice Address - Street 1:1 MERCADO ST STE 145
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7311
Practice Address - Country:US
Practice Address - Phone:970-247-5543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-12
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR17306700163W00000X
PARN652191163W00000X
DEL1-0044995163W00000X
NJ25ME00059301367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse