Provider Demographics
NPI:1003900663
Name:WARDEN, MEAGHAN (PAAA)
Entity Type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:
Last Name:WARDEN
Suffix:
Gender:F
Credentials:PAAA
Other - Prefix:
Other - First Name:MEAGHAN
Other - Middle Name:
Other - Last Name:GILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAAA
Mailing Address - Street 1:PO BOX 7337
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30604
Mailing Address - Country:US
Mailing Address - Phone:706-543-3449
Mailing Address - Fax:706-543-5744
Practice Address - Street 1:1199 PRINCE AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606
Practice Address - Country:US
Practice Address - Phone:706-543-3449
Practice Address - Fax:706-543-5744
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA779839335AMedicaid
GA32BBBZNMedicare PIN