Individual
MEGAN M INGERSOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CRNA
Contact information
Practice address
2100 MADISON AVE, GRANITE CITY, IL 62040-4701
(618) 798-3857
Mailing address
2100 MADISON AVE, GRANITE CITY, IL 62040-4701
(618) 798-3857
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041343885
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209006975
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SS#-001
—
IL
Enumeration date
02/29/2008
Last updated
07/08/2008
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