Individual
MEGHAN MARIE PROVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
21 DWIGHT ROAD, SUITE 104, LONGMEADOW, MA 01106-1765
(413) 795-4555
(413) 794-9448
Mailing address
280 CHESTNUT ST FL 2, SPRINGFIELD, MA 01199-1001
(413) 794-5700
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN2301093
MA
Other
Enumeration date
07/11/2019
Last updated
03/15/2023
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