Individual provider · NPI-1

Meghana Challa

Nurse Practitioner, Family · Southgate, MI

NPI number1265272900
StatusActive
Last updated in NPPESMay 30, 2024

Details

NPI
1265272900
Entity type
Individual (NPI-1)
Name
Meghana Challa
Sex
Female
Sole proprietor
No
Enumeration date
May 30, 2024
Certification date
May 30, 2024
Last updated
May 30, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family4704384738MIYes

Practice location

15150 Fort St
Southgate, MI 48195-1302

Phone 734-282-4800

Mailing address

50409 Teton Ridge Rd
Northville, MI 48168-6852

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