Provider Demographics
NPI:1487318903
Name:BURGMAIER, MEGAN JOSIE (FNP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:JOSIE
Last Name:BURGMAIER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1274 JOSHUA AVE
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:IA
Mailing Address - Zip Code:50801-8130
Mailing Address - Country:US
Mailing Address - Phone:641-344-9212
Mailing Address - Fax:
Practice Address - Street 1:1274 JOSHUA AVE
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-8130
Practice Address - Country:US
Practice Address - Phone:641-344-9212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-30
Last Update Date:2021-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA164686363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner