Provider Demographics
NPI:1447929013
Name:PERRAUT, MEGAN ASHLEY (NP)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:ASHLEY
Last Name:PERRAUT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 SHAWNEE EST
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:25213-9710
Mailing Address - Country:US
Mailing Address - Phone:304-550-0660
Mailing Address - Fax:
Practice Address - Street 1:3701 MACCORKLE AVE SE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1525
Practice Address - Country:US
Practice Address - Phone:304-720-2345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV107213363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily