Provider Demographics
NPI:1487986998
Name:HERDENER, MEGAN E (ARNP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:E
Last Name:HERDENER
Suffix:
Gender:F
Credentials:ARNP
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Mailing Address - Street 1:9601 BUJACICH RD NW
Mailing Address - Street 2:WA CORRECTIONS CENTER FOR WOMEN
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-8300
Mailing Address - Country:US
Mailing Address - Phone:253-858-4665
Mailing Address - Fax:253-858-4225
Practice Address - Street 1:9601 BUJACICH RD NW
Practice Address - Street 2:WA CORRECTIONS CENTER FOR WOMEN
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-8300
Practice Address - Country:US
Practice Address - Phone:253-858-4665
Practice Address - Fax:253-858-4225
Is Sole Proprietor?:No
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP3007169363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily