Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | AP137738 | TX |
NPI | 1003309998 |
---|---|
Provider Name | Megan Marie Wait |
First Address | Amarillo, TX 79124-2118 |
Second Address | Amarillo, TX 79124-2118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2018 |
Last Update Date | 09/05/2019 |