Basic Information
Provider Information
NPI: 1972866440
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AHRNDT
FirstName: MEGAN
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: LOEN
OtherFirstName: MEGAN
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: CRNA
OtherLastNameType: 1
Mailing Information
Address1: 3701 12TH ST N
Address2: SUITE 202
City: SAINT CLOUD
State: MN
PostalCode: 563032255
CountryCode: US
TelephoneNumber: 3202583090
FaxNumber: 3202583095
Practice Location
Address1: 3701 12TH ST N
Address2: SUITE 202
City: SAINT CLOUD
State: MN
PostalCode: 563032255
CountryCode: US
TelephoneNumber: 3202583090
FaxNumber: 3202583095
Other Information
ProviderEnumerationDate: 06/20/2012
LastUpdateDate: 06/20/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XR 166231-1MNY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


Home