Provider Demographics
NPI:1053905430
Name:CARROLL, MEGAN GREY (RN)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:GREY
Last Name:CARROLL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57490 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:MARTINS FERRY
Mailing Address - State:OH
Mailing Address - Zip Code:43935-9750
Mailing Address - Country:US
Mailing Address - Phone:740-359-8160
Mailing Address - Fax:
Practice Address - Street 1:57490 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:MARTINS FERRY
Practice Address - State:OH
Practice Address - Zip Code:43935-9750
Practice Address - Country:US
Practice Address - Phone:740-359-8160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH346-586163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse