Individual
MRS. MEGHAN DANELLE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3550 S 4TH ST STE B, LEAVENWORTH, KS 66048-5071
(913) 680-6200
(913) 680-6348
Mailing address
3550 S 4TH ST STE B, LEAVENWORTH, KS 66048-5071
(913) 680-6200
(913) 680-6348
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-02415
KS
363A00000X
Physician Assistant
PA06440
TX
363AM0700X
Medical Physician Assistant
15-02415
KS
363AM0700X
Medical Physician Assistant
TX TEMPORARY
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15-02415
STATE LICENSE
KS
Enumeration date
10/14/2009
Last updated
02/16/2022
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