Individual
MS. MEGAN ANN PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1109 BROOKDALE ST STE C, MARTINSVILLE, VA 24112-4543
(276) 666-7545
Mailing address
1109 BROOKDALE ST STE C, MARTINSVILLE, VA 24112-4543
(276) 666-7545
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
17579
SC
363LP0200X
Pediatric Nurse Practitioner
Primary
0024170259
VA
363LP0200X
Pediatric Nurse Practitioner
236844
MA
Other
Enumeration date
05/19/2007
Last updated
09/04/2012
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