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Individual

MEGAN MCMACKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
13714 FORDHAM CT, APPLE VALLEY, MN 55124-7953
(612) 600-7072
Mailing address
13714 FORDHAM CT, APPLE VALLEY, MN 55124-7953
(612) 600-7072

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2483987
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2483987
BOARD OF NURSING
MN
Enumeration date
01/06/2021
Last updated
01/06/2021
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