Provider Demographics
NPI:1750951273
Name:TEMPLES, MEGAN C (NP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:C
Last Name:TEMPLES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 BEVERLY DR
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:IL
Mailing Address - Zip Code:61944-1903
Mailing Address - Country:US
Mailing Address - Phone:217-808-1215
Mailing Address - Fax:
Practice Address - Street 1:109 BEVERLY DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:IL
Practice Address - Zip Code:61944-1903
Practice Address - Country:US
Practice Address - Phone:217-808-1215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209023438363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily