Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 006393 | AZ |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 006393 | AZ |
NPI | 1194045740 |
---|---|
Provider Name | Dr. Megan Nicole Wasson |
First Address | Phoenix, AZ 85054-4502 |
Second Address | Phoenix, AZ 85054-4502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2010 |
Last Update Date | 02/10/2020 |