Doctor Name: | MARY MEADOWS |
NPI Number: | 1164486270 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | RN0000130096 |
Business Practice Address: | 4895 E Main St Suite C Erin, TN - 370614115 |
Business Phone Number: | 9312892929 |
Business Fax Number: | 9312892930 |
Mailing Address: | 4895 E Main St, Suite C ERIN |
State: | TN |
Postal Code: | 370614115 |
Phone Number: | 9312892929 |
Fax Number: | 9312892930 |
NPI Enumeration Date: | 04/14/2006 |
NPI Last Update Date: | 10/01/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN0000130096 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |