Provider Demographics
NPI:1053613000
Name:VARCHO, MEGAN KATHERINE (ARNP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:KATHERINE
Last Name:VARCHO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3319 SPRING ST
Mailing Address - Street 2:202
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2125
Mailing Address - Country:US
Mailing Address - Phone:563-359-1716
Mailing Address - Fax:563-359-4634
Practice Address - Street 1:3319 SPRING ST
Practice Address - Street 2:202
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2125
Practice Address - Country:US
Practice Address - Phone:563-359-1716
Practice Address - Fax:563-359-4634
Is Sole Proprietor?:No
Enumeration Date:2010-11-24
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA117610363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0184500001Medicare NSC
IL336552Medicare PIN
IL0184500003Medicare NSC
IA07364Medicare PIN