Individual
MEGHAN LOUISE DUNNAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
677 N COVE COLONY WAY, EAGLE, ID 83616-4675
(406) 465-1772
Mailing address
677 N COVE COLONY WAY, EAGLE, ID 83616-4675
(406) 465-1772
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN45688
ID
Other
Enumeration date
07/23/2013
Last updated
07/23/2013
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