Provider Demographics
NPI:1235015892
Name:MEGGERSON, LISA SHAWN
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:SHAWN
Last Name:MEGGERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 MARSH RD
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-8630
Mailing Address - Country:US
Mailing Address - Phone:775-315-7724
Mailing Address - Fax:
Practice Address - Street 1:874 MARSH RD
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-8630
Practice Address - Country:US
Practice Address - Phone:775-315-7724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider