Individual
MEGAN M CONOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2321 E GALA ST STE 3, MERIDIAN, ID 83642-7692
(208) 888-5848
(208) 888-0884
Mailing address
2321 E GALA ST STE 3, MERIDIAN, ID 83642-7692
(208) 888-5848
(208) 888-0884
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
PA-1975
ID
208D00000X
General Practice Physician
PA-1975
ID
363A00000X
Physician Assistant
Primary
PA-1975
ID
363AS0400X
Surgical Physician Assistant
4798
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA-1975
STATE OF IDAHO PA-C LIC
ID
Enumeration date
01/06/2011
Last updated
07/26/2022
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