Provider Demographics
NPI:1679905921
Name:DUFFANY, MEGHAN WEAKE
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:WEAKE
Last Name:DUFFANY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 PLEASANT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WEST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02379-1506
Mailing Address - Country:US
Mailing Address - Phone:508-566-1155
Mailing Address - Fax:508-563-3602
Practice Address - Street 1:22 PLEASANT ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WEST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02379-1506
Practice Address - Country:US
Practice Address - Phone:508-566-1155
Practice Address - Fax:508-563-3602
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN262401363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health