Provider Demographics
NPI:1487361184
Name:ROMBOLD, MEGAN (DNP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:ROMBOLD
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-1650
Mailing Address - Country:US
Mailing Address - Phone:724-777-5586
Mailing Address - Fax:
Practice Address - Street 1:135 TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-9549
Practice Address - Country:US
Practice Address - Phone:714-399-3931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-01
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026226363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner