Individual
MEGHAN LYNN LOVELLETTE KOEHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
253 SAGAMORE PKWY W, WEST LAFAYETTE, IN 47906-1501
(765) 448-8000
(765) 838-7984
Mailing address
1200 W WHITE RIVER BLVD, RCS PROVIDER ENROLLMENT, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71008437A
IN
363LF0000X
Family Nurse Practitioner
Primary
71008437A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300020710
—
IN
Enumeration date
10/04/2018
Last updated
10/26/2021
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