Individual
MRS. MEGAN ANN TOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1701 S CREASY LN, LAFAYETTE, IN 47905-4972
(765) 502-4000
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
71004084A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000805906
ANTHEM
—
01
—
12511350
CAQH
—
05
—
201136200
—
IN
Enumeration date
10/05/2012
Last updated
03/13/2021
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