Basic Information
| Provider Information | |||||||||
| NPI: | 1033639513 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DELLINGER | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | |||||||||
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| Credential: | RN | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ROGERS | ||||||||
| OtherFirstName: | MEGAN | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1980 CROSSROAD SCHOOL RD | ||||||||
| Address2: | |||||||||
| City: | HEDGESVILLE | ||||||||
| State: | WV | ||||||||
| PostalCode: | 254273899 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 180 GRAFTON LN | ||||||||
| Address2: | |||||||||
| City: | BERRYVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226112576 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5409552400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2017 | ||||||||
| LastUpdateDate: | 06/26/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0807X | 1238057 | VA | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Child & Adolescent |
No ID Information.