Provider Demographics
NPI:1669096798
Name:MOYER, MEGAN (BSN RN)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MOYER
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 RED FOX RUN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-9736
Mailing Address - Country:US
Mailing Address - Phone:513-571-3581
Mailing Address - Fax:
Practice Address - Street 1:3650 RED FOX RUN
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-9736
Practice Address - Country:US
Practice Address - Phone:513-571-3581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.315669163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse