Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | AP130420 | TX |
Y | 363LG0600X | Nurse Practitioner - Gerontology | RN265852 | GA |
N | 363LW0102X | Nurse Practitioner - Women's Health | AP130420 | TX |
NPI | 1053769570 |
---|---|
Provider Name | Megan Naylor Massey |
First Address | Atlanta, GA 30309-1281 |
Second Address | Atlanta, GA 30309-1281 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2016 |
Last Update Date | 12/06/2017 |