Provider Demographics
NPI:1093485864
Name:MEEKS, MICHELLE KAY (RN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:KAY
Last Name:MEEKS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3663 WASHINGTON PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44105-3177
Mailing Address - Country:US
Mailing Address - Phone:216-799-8590
Mailing Address - Fax:
Practice Address - Street 1:3663 WASHINGTON PARK BLVD
Practice Address - Street 2:
Practice Address - City:NEWBURGH HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44105-3177
Practice Address - Country:US
Practice Address - Phone:216-799-8590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH372823163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse