Doctor Name: | MRS. MELISSA MEAGAN STATES |
NPI Number: | 1427367804 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN-CNP |
License Number: | R0071397 |
Business Practice Address: | 1610 S Main St Kingfisher, OK - 737504600 |
Business Phone Number: | 4053755222 |
Business Fax Number: | 4053755234 |
Mailing Address: | 1610 S Main St, KINGFISHER |
State: | OK |
Postal Code: | 737504600 |
Phone Number: | 4053755222 |
Fax Number: | 4053755234 |
NPI Enumeration Date: | 10/01/2010 |
NPI Last Update Date: | 04/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R0071397 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |