Provider Demographics
NPI:1073208310
Name:ORIENTAL, MEKA
Entity Type:Individual
Prefix:
First Name:MEKA
Middle Name:
Last Name:ORIENTAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 CARLYSLE PARK DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-2242
Mailing Address - Country:US
Mailing Address - Phone:678-359-2049
Mailing Address - Fax:
Practice Address - Street 1:1205 CARLYSLE PARK DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-2242
Practice Address - Country:US
Practice Address - Phone:678-359-2049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-11
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty