Provider Demographics
NPI:1578344552
Name:JAMES, MEGAN NICOLE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:NICOLE
Last Name:JAMES
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 N CAUSEWAY STE A
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32169-5328
Mailing Address - Country:US
Mailing Address - Phone:386-424-3320
Mailing Address - Fax:386-424-3319
Practice Address - Street 1:161 N CAUSEWAY STE A
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32169-5328
Practice Address - Country:US
Practice Address - Phone:386-424-3320
Practice Address - Fax:386-424-3319
Is Sole Proprietor?:No
Enumeration Date:2023-10-06
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11029062363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health