Doctor Name: | JODY BENNETT-MEEHAN |
NPI Number: | 1467760447 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | MA054532 |
Business Practice Address: | 215 E Water St Muncy, PA - 177568828 |
Business Phone Number: | 5705468282 |
Business Fax Number: | |
Mailing Address: | 215 E Water St, MUNCY |
State: | PA |
Postal Code: | 177568828 |
Phone Number: | 5705468282 |
Fax Number: | |
NPI Enumeration Date: | 09/23/2010 |
NPI Last Update Date: | 09/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | MA054532 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |