Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0000X | Nurse Practitioner - Neonatal | 750927 | TX |
Y | 363LN0000X | Nurse Practitioner - Neonatal | AP124270 | TX |
NPI | 1053758862 |
---|---|
Provider Name | Megan Michelle Withoff |
First Address | San Antonio, TX 78229-3561 |
Second Address | San Antonio, TX 78229-3539 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2013 |
Last Update Date | 10/12/2020 |