Basic Information
| Provider Information | |||||||||
| NPI: | 1619219318 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOOD | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | ANNE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NP-C, CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 TEXAS STATION CT | ||||||||
| Address2: | |||||||||
| City: | TIMONIUM | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210938286 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106833380 | ||||||||
| FaxNumber: | 4106833121 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 TEXAS STATION CT | ||||||||
| Address2: | |||||||||
| City: | TIMONIUM | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210938286 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106833380 | ||||||||
| FaxNumber: | 4106833121 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2013 | ||||||||
| LastUpdateDate: | 03/20/2013 | ||||||||
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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 | 363LA2200X | R197272 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.