Basic Information
Provider Information
NPI: 1154628022
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARNEY
FirstName: MEGAN
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1514 AUDUBON LN
Address2:  
City: MOREHEAD CITY
State: NC
PostalCode: 285578000
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2000 NEUSE BLVD
Address2: CAROLINA EAST MEDICAL CENTER
City: NEW BERN
State: NC
PostalCode: 285603449
CountryCode: US
TelephoneNumber: 2526338111
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/11/2011
LastUpdateDate: 02/26/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/26/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X0010-02728NCY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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