Basic Information
| Provider Information | |||||||||
| NPI: | 1336661784 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CORRELL | ||||||||
| FirstName: | MEGAN | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1049 WESTERN AVE | ||||||||
| Address2: | |||||||||
| City: | CHILLICOTHE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 456011104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7407734366 | ||||||||
| FaxNumber: | 7407757855 | ||||||||
| Practice Location | |||||||||
| Address1: | 541 SR 664N | ||||||||
| Address2: | SUITE C | ||||||||
| City: | LOGAN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7403856594 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2017 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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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 | 363LP0808X | APRN.CNP.021190 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.