| Doctor Name: | CRYSTAL RUDDELL MEREDITH |
| NPI Number: | 1881845824 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | PA.200237 |
| Business Practice Address: | 187 Ninth Street Jena, LA - 71342 |
| Business Phone Number: | 3189929296 |
| Business Fax Number: | 3189929125 |
| Mailing Address: | 187 Ninth Street, P.o. Box 2780 JENA |
| State: | LA |
| Postal Code: | 713422780 |
| Phone Number: | 3189929200 |
| Fax Number: | 3189929245 |
| NPI Enumeration Date: | 10/08/2008 |
| NPI Last Update Date: | 10/14/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA.200237 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |