Basic Information
Provider Information
NPI: 1518372614
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEHRER
FirstName: MEGAN
MiddleName: MARIE-LEARY
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9 E CENTRAL ST
Address2:  
City: FRANKLIN
State: MA
PostalCode: 020381483
CountryCode: US
TelephoneNumber: 5084409006
FaxNumber:  
Practice Location
Address1: 9 E CENTRAL ST
Address2:  
City: FRANKLIN
State: MA
PostalCode: 020381483
CountryCode: US
TelephoneNumber: 5085303140
FaxNumber: 5085303142
Other Information
ProviderEnumerationDate: 06/26/2014
LastUpdateDate: 04/10/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XRN284797MAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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